咳嗽变异型哮喘32例临床分析  

Clinical analysis of 32 cases with cough variation asthma

作　　者：陈莉文[1] 肖波[1] 席玉胜[1] 徐小文[1] 朱敏敏[1] 孙星梅[1] 

机构地区：[1]中国人民解放军第421医院呼吸科,广东广州510310

出　　处：《中国现代医学杂志》2004年第3期107-108,111,共3页China Journal of Modern Medicine

摘　　要：目的　了解咳嗽变异型哮喘的诊断和治疗情况。方法　回顾性研究咳嗽变异型哮喘的临床特点 ,诊疗方法和治疗效果。结果　临床特点及诊断依据 :起病以上呼吸道感染诱发的占 6 2 .5 % ,余无明确诱因 ;以咳嗽为唯一表现 ;或伴有胸闷 ;或伴少许白痰。咳嗽均有夜间发作尤其是后半夜 3～ 5时明显 ,其他时间亦有不规律发作 ,呈刺激性、阵发性剧烈咳嗽 ;多数肺部呼吸音正常 ,少数呼吸音稍增粗 ,均无干湿罗音 ;胸部X线检查均无异常 ;肺功能正常者占 96 .9% ,进一步行组织胺激发试验均呈阳性。因此 ,确诊CVA ;另 1例肺功能FVC 6 1.2 % ,FEV 14 7.7%和FEV1/FVC 6 7.6 % ,支气管扩张试验呈阳性而确诊CVA。二治疗方法联合应用皮质激素、茶碱、抗过敏类。未用抗菌素者在应用上述治疗后症状控制不理想的 ,予加用了红霉素或 /和喹诺酮类药物。有 2 4例患者在治疗 3d内、6例在治疗 1,2周症状缓解 ;但在减药量过程症状都有轻度到中度 (治疗前症状定为重度为参照 )的反复。 31例组织胺激发试验阳性者治疗 1月后停药 3天复查该试验均转为阴性。治愈并停药时间 :1月内的有 10例 ;1～ 3月的有 9例 ;3个月后的 2例 ;6个月的 8例 ;9个月的 2例 ;最长的 1例于治疗 1年后才治愈停药 ,跟踪观察 5年未再发 ;有过敏性咽喉炎者仍间歇出?Objective: To realize the diagnosis and the treatment of cough variation asthma (CVA) . Methods:To review the cases of CVA and study its clinical characters, diagnosis and curative effect.Results: The clinical characters and diagnosis ofCVA: 62.5 percent of cases of CVA were causesed by upper respiratory infection; and the others were causeless; Cough was the only symptom in some cases of CVA; or with chest distress; or with little white phlegm. Cough was excitant and paroxysmal and severe .It happened at night especially at 3～5 o'clock after midnight, while at the other time there were irregularly cough cases; The breathing was normal in more cases of CVA but rough slightly in less cases, there were not moist rale and rhonchi in all cases;X-ray examination in Chest was nomal in all cases of CVA;There were normal lung fountion test in 96.9 percent of cases of CVA, when their broncho-excited-tests by histamine were positive, CVA may be diagnosed. There was a case with FVC61.2%, FEV 147.7%, FEV1/FVC 67.6% and its diagnosis of CVA was by positive bronchodilatation test. Treatment of CVA: cortical hormone combined with theophyllin and antianaphylactin were used ;if the curative effect wasn't satisfactory, Erythromycin and xacin could be added. The symptom of CVA removed in 24 cases during 3 days of treatment; and 6 cases during 1～2 weeks of treatment. But the symptom could recur slightly or middle( symptom before treatment was refered to severely. After one month's treatment broncho-excited-tests by histamine was turned to negative from positive in 31 cases(the test was went on after 3 days' of stopping drugs). The time of curing and stopping drugs: there were 10 cases within one month; 9 cases between 1～3 months; 2 cases after 3 months; 8 cases after 6 months; 2 case after 9 months and a longest case after one year. There hadn't been recurrence in 5 years of following. Sore throat and cough may attack intermittently, but with less tense and managing to cope with.Conclusions: The answer to what asthma c

关 键 词：咳嗽 变异型哮喘 上呼吸道感染 

分 类 号：R562.25[医药卫生—呼吸系统]