慢性咳嗽的病因分布及其治疗研究  

Analysis of causes and treatment methods of chronic cough

作　　者：江毅芳[1] 乐家振[1] 杨海斌[1] 

机构地区：[1]厦门大学附属中山医院,福建厦门361004

出　　处：《临床肺科杂志》2011年第9期1359-1360,共2页Journal of Clinical Pulmonary Medicine

摘　　要：目的探讨慢性咳嗽常见病因分布及治疗方法。方法介绍在我院呼吸内科及耳鼻喉科门诊或住院的157例慢性咳嗽患者的病史、体检、血常规、心电图、胸部X线、肺功能、副鼻窦X线及心脏彩超等进行检查,确定病因诊断及相应的治疗。结果慢性咳嗽病因分布的顺序依次为:上气道咳嗽综合征40例(25.5%),咳嗽变异性哮喘33例(21.0%),胃食管反流性咳嗽29例(18.5%),感染后咳嗽27例(17.2%),嗜酸粒细胞性支气管炎7例(4.5%),血管紧张素转化酶抑制剂(ACEI)类药物诱导的药物性咳嗽7例(4.5%),慢性心功能不全6例(3.8%),原因未明8例(5%)。149例(94.9%)患者经病因治疗后咳嗽症状消失或明显减轻。结论慢性咳嗽常见的主要病因为:上气道咳嗽综合征、咳嗽变异性哮喘、胃食道反流性咳嗽等。慢性咳嗽病因复杂,误诊率高,应针对病因予以治疗,明确病因是治疗成功的关键。Objective To explore the common causes and treatment methods of chronic cough.Methods According to ＂the Guideline on Diagnosis and Treatment of Chronic cough＂,which was established by the Chinese Medical Association Respiratory Branch,we performed history taking,physical examination,blood routine test,ECG,chest X-ray or CT,pulmonary function test,bronchial dilation test,paranasal sinuses X-ray or CT and Color Doppler Flow Imaging（CDFI） in 157 patients with chronic cough.Causes were confirmed by effective treatment respectively.Results The cause of chronic cough was confirmed in 149 patients.The causes included Upper airway cough syndrome（UACs）in 40 patients（25.5%）,cough variant asthma（CVA） in 33 patients（21.0%）,gastroesophageal reflux cough（GERC）in 29 patients（18.5%）,post-infection cough（PIC）in 27 patients（17.2%）,ensinophilic bronchitis（EB）in 7 patients（4.5%）,angiotensin converting enzyme inhibitor（ACEI） induction in 7 patients（4.5%）,chronic heart insufficiency in 6 patients（3.8%）.8 patients had not been definitely diagnosed.After specific treatment,cough disappeared or obviously alleviated in 149 patients（94.9%） confirmedly diagnosed.Conclusions The main causes of chronic cough are UACs,CVA,GERC.The causes of chronic cough are complex,and misdiagnosis rate is high.Treatment should be based on specific causes,and a clear cause is the key to treatment.

关 键 词：慢性咳嗽 上气道咳嗽综合征 哮喘 胃食管反流性咳嗽 治疗 

分 类 号：R56[医药卫生—呼吸系统]