深圳地区慢性咳嗽病因构成和危险因素分析

The Spectrum of Causes and Risk Factors for Chronic Cough in Shenzhen

目的:调查深圳地区慢性咳嗽的病因分布及危险因素,为经验性治疗提供指导。方法:遵照我国慢性咳嗽诊治指南的诊断标准和流程,对2014年4月至2016年5月在深圳市第二人民医院就诊的慢性咳嗽患者进行诊治,同时行相关危险因素的问卷式调查,根据治疗后的反应,最终确定病因诊断。结果:共入选慢性咳嗽患者115例,男62例,女53例。慢性咳嗽病因构成比前5位依次为:咳嗽变异性哮喘(CVA)41例(31.1%),上气道咳嗽综合征(UACS)35例(26.5%),胃食管反流(GERC)16例(12.1%),嗜酸粒细胞性支气管炎(EB)12例(9.6%),感染后咳嗽(PIC)8例(6.1%)。最终确诊的慢性咳嗽患者中,一重病因93例(85.3%),二重病因15例(13.8%),三重病因1例(0.9%)。鼻部疾患是慢性咳嗽患者的危险因素,32.2%的慢性咳嗽患者患有慢性鼻部疾病。结论:CVA、UACS、GERC、EB和PIC是深圳地区慢性咳嗽的常见病因。鼻部疾病是慢性咳嗽患者的重要危险因素。

Objective To explore the spectrum of causes and its risk factors for chronic cough in Shenzhen, which are important in the diagnostic procedure of chronic cough. Methods Patients with chronic cough treated at respiratory clinic of the second people＇s hospital of Shenzhen from April 2014 to May 2016 were included in this study. The causes were investigated with a well-established protocol according to The Chinese Respiratory Society guidelines for management of cough, and a questionnaire of risk factors was performed. The final diagnosis was made based on clinical manifestations, examination findings and a positive response to therapy. Results Totally 115 patients with chronic cough aged 18 to 76 years old were enrolled, the 5 leading causes of the 115 patients with chronic cough were cough variant asthma （CVA） （n=41,33.3 %）, upper airway cough syndrome （UACS） （n=35,26.1%）, gastroesophageal reflux （GERC） （n=16,12.2 %）, eosinophilic bronchitis （EB） （n=12, 9.6 %）, post-infection cough （PIC） （n=8,6.1%）. The causes of chronic cough were defined in the patients, with a single cause found in 93 patients （85.3 %）, and double causes in 15 patients （13.8 %）, and triple causes in 1 patient （0.9 %）. Nasal disease was an important risk factor to the development of chronic cough, which was found in 32.2 % of the patients with chronic cough. Conclusion CVA, UACS, GERC, EB and PIC were the 5 leading causes for patients with chronic cough in Shenzhen. Nasal disease was an important risk factor to chronic cough.