中国综合临床
中國綜閤臨床
중국종합림상
CLINICAL MEDICINE OF CHINA
2011年
10期
1041-1043
,共3页
慢性咳嗽%临床症状%诊断价值
慢性咳嗽%臨床癥狀%診斷價值
만성해수%림상증상%진단개치
Chronic cough%Symptom%Diagnostic
目的 探讨常见慢性咳嗽的病因及疾病表现的临床意义,为经验性治疗提供依据.方法 按慢性咳嗽的病因诊断流程对160例患者的病因构成进行分析,比较常见病因慢性咳嗽患者的咳嗽时相、性质、诱发因素及相关伴随症状,统计方法采用U检验,计算P值.结果 共入选160例2009年1月至12月宜昌市中心人民医院呼吸科门诊慢性咳嗽患者,其中常见病因分布依次为咳嗽变异性哮喘(CVA) 72例占45.00％、上气道咳嗽综合征(UACS) 54例占33.75％、嗜酸性粒细胞性支气管炎(EB) 14例占8.75％、胃食管反流性咳嗽(GERC)9例占5.63％,其他病因共11例、占6.87％.不同病因组临床表现有差异.CVA患者夜间咳嗽构成比为52.8(38/72),明显高于其他病因；UACS患者以白天咳嗽为主,70.2％伴有鼻后滴流症状,且绝大部分伴有鼻炎相关症状或有鼻炎病史,高于其他各组；GERC患者饮食相关咳嗽占66.7％,77.8％伴有反流症状明显高于其他病因组；上述症状差异均有统计学意义.但EB患者临床症状无特异性.结论 各种病因的慢性咳嗽具有一定的临床特征,慢性咳嗽病因构成及咳嗽时相、部分伴随症状对病因诊断具有一定的参考价值.
目的 探討常見慢性咳嗽的病因及疾病錶現的臨床意義,為經驗性治療提供依據.方法 按慢性咳嗽的病因診斷流程對160例患者的病因構成進行分析,比較常見病因慢性咳嗽患者的咳嗽時相、性質、誘髮因素及相關伴隨癥狀,統計方法採用U檢驗,計算P值.結果 共入選160例2009年1月至12月宜昌市中心人民醫院呼吸科門診慢性咳嗽患者,其中常見病因分佈依次為咳嗽變異性哮喘(CVA) 72例佔45.00％、上氣道咳嗽綜閤徵(UACS) 54例佔33.75％、嗜痠性粒細胞性支氣管炎(EB) 14例佔8.75％、胃食管反流性咳嗽(GERC)9例佔5.63％,其他病因共11例、佔6.87％.不同病因組臨床錶現有差異.CVA患者夜間咳嗽構成比為52.8(38/72),明顯高于其他病因；UACS患者以白天咳嗽為主,70.2％伴有鼻後滴流癥狀,且絕大部分伴有鼻炎相關癥狀或有鼻炎病史,高于其他各組；GERC患者飲食相關咳嗽佔66.7％,77.8％伴有反流癥狀明顯高于其他病因組；上述癥狀差異均有統計學意義.但EB患者臨床癥狀無特異性.結論 各種病因的慢性咳嗽具有一定的臨床特徵,慢性咳嗽病因構成及咳嗽時相、部分伴隨癥狀對病因診斷具有一定的參攷價值.
목적 탐토상견만성해수적병인급질병표현적림상의의,위경험성치료제공의거.방법 안만성해수적병인진단류정대160례환자적병인구성진행분석,비교상견병인만성해수환자적해수시상、성질、유발인소급상관반수증상,통계방법채용U검험,계산P치.결과 공입선160례2009년1월지12월의창시중심인민의원호흡과문진만성해수환자,기중상견병인분포의차위해수변이성효천(CVA) 72례점45.00％、상기도해수종합정(UACS) 54례점33.75％、기산성립세포성지기관염(EB) 14례점8.75％、위식관반류성해수(GERC)9례점5.63％,기타병인공11례、점6.87％.불동병인조림상표현유차이.CVA환자야간해수구성비위52.8(38/72),명현고우기타병인；UACS환자이백천해수위주,70.2％반유비후적류증상,차절대부분반유비염상관증상혹유비염병사,고우기타각조；GERC환자음식상관해수점66.7％,77.8％반유반류증상명현고우기타병인조；상술증상차이균유통계학의의.단EB환자림상증상무특이성.결론 각충병인적만성해수구유일정적림상특정,만성해수병인구성급해수시상、부분반수증상대병인진단구유일정적삼고개치.
Objective To evaluate the common causes of chronic cough and the diagnostic value of clinical symptoms,and provide evidences for empirical treatment.Methods The causes of patients with chronic cough were evaluated by a validated systematic diagnostic protocol.The characteristics of the cough timing,characters,incentives and associated manifestations of chronic cough with different causes were compared.Results A total of 160 patients with at least 8 weeks of chronic cough and normal chest radiographswere recruited from the Department of respiratory diseases of Yichang Central Hospital between Jan.to Dec.2009.The most common causes of chronic cough were cough variant asthma (CVA,n =72,45％ ),upper airway cough syndrome ( UACS,n =54,33.75％ ),eosinophilic bronchitis ( EB,n =14,8.75％ ),gastroesophageal reflux-related chronic cough ( GERC,n =9,5.63％ ),other etiologies ( n =11,6.87％ ).Significant differences were observed in different etiological subtypes.The incidence of nocturnal cough in CVA was 52.8％ ( 38/72 ),significantly higher than others types ; URCS patients manifested more day coughs,with 70.2％ postnasal drip syndrome and significantly more cases had the history of nasal diseases compared with other types.The specificity of cough associated with meals in GERC were 66.7％,and the regurgitation associated symptom in GERC were77.8％,significantly higher than other types.However no special syndromes were observed in EB patients.Conclusion All kinds of chronic coughs have specific symptoms.The spectrum of causes and clinical features of chronic cough are important in the diagnostic procedure of chronic cough.
