慢性咳嗽病因分布的前瞻性研究

A prospective study on etiology of chronic cough

目的了解深圳地区慢性咳嗽病因分布的特点。方法以中华医学会制定的《咳嗽的诊断与治疗指南（2009版）》为指导，对最终符合要求的136例，以咳嗽为主要或惟一症状，咳嗽持续时间≥8周，胸部x线片正常的患者进行病因分析。结果经检查和治疗病因诊断明确者125例，病因不明者11例；其中单一病因者104例（83．20％，104／125），复合病因者21例（16．80％，21／125）。其病因分布前4位为咳嗽变异型哮喘（CVA）57例（36．31％，57／157）、上气道咳嗽综合征（UACS）41例（26．11％，41／157）、嗜酸细胞性支气管炎（EB）17例（10．83％，17／157）、职业损害（分别为有害、有毒物质吸入等）10例（6．37％，10／157）。结论深圳地区慢性咳嗽的常见病因为CVA、UACS、EB，由于工业化程度较高，在生产过程中工人对吸入有害、有毒气体和粉尘引起咳嗽认识不足，要引起高度重视。

Objective To investigate the characteristic of etiology of chronic cough in Shenzhen. Methods The chronic cough etiology was analyzed in 136 cases with the guidance of cough diagnosis and treatment guidelines（2009 editions） published by Chinese Medical Association. The cough was the main or sole symptom,the duration was no less than 8 weeks and chest X-ray film was normal. Results The causes of chronic cough was confirmed in 125 patients and was not definitely diagnosed in 11 patients by inspection and treatment. Cough due to single cause was found in 104 patients （83.20%, 104/125）, due to compound causes was found in 21 patients （ 16.80%, 21/125 ）. The first 4 etiologies were cough variant asthma（CVA） with 57 patients （36.31%,57/157）,upper airway cough syndrome （UACS） with 41 patients （26.11%, 41/157 ）, eosinophilic bronchitis （EB） with 17 patients （ 10.83%, 17/157）, occupational injury （including harmful,toxic substances inhalation, etc.） with 10 patients （6.37%, 10/157）. Conclusions The most common cause of chronic cough in Shenzhen is CVA, UACS, EB. Due to the developed industrialization, there is a lack of understanding the cough course of inhaling more harmful and toxic gases and substances in the manufacturing process. So this should be paid more attention.