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1.
Background and objective:   Atopic cough (AC) is an established clinical entity in Japan, in which patients present with a chronic persistent non-productive cough. Exhaled nitric oxide (NO) is a biomarker of eosinophilic airway inflammation. The present study examined whether exhaled NO levels were increased in AC in comparison with cough variant asthma (CVA) and bronchial asthma (BA).
Methods:   Consecutive patients presenting with an isolated cough lasting at least 8 weeks were enrolled in the study. The aetiology of the chronic cough was determined according to the Japanese Respiratory Society guidelines for management of cough. Exhaled NO, capsaicin cough sensitivity (capsaicin concentration eliciting five or more coughs (C5)) and bronchial reversibility were measured at the patients' first visit. Bronchial responsiveness (PC20 to methacholine) was measured at their second visit following a 6-day course of bronchodilator therapy.
Results:   There were 58 patients recruited and fully investigated; of these 9 and 11 patients were diagnosed with AC and CVA, respectively, as single causes of chronic cough. Ten patients with BA who had not received corticosteroid therapy in the previous 4 weeks and who attended the same clinic in the same time period acted as controls. Exhaled NO levels in patients with AC were significantly lower than those in patients with CVA and BA. There was no significant difference in the exhaled NO levels between patients with CVA and BA.
Conclusions:   Exhaled NO may reflect eosinophilic inflammation of peripheral airways and its measurement may be useful in differentiating CVA from AC and other causes of chronic non-productive cough.  相似文献   

2.
目的调查青岛市亚急性、慢性咳嗽中咳嗽变异性哮喘(CVA)的发病率及相关因素,对其进行分析。方法选取2013年7月至2014年6月期间诊断亚急性及慢性咳嗽,胸片无异常的患者504例作为研究对象,回顾性分析所有研究对象的病史、检查及诊断结果,分析CVA的发病率及发病相关因素。结果青岛市亚急性、慢性咳嗽最常见原因均为CVA,CVA与过敏性鼻炎、哮喘家族史、个人过敏史、宠物相关(P0.05),CVA患者中男女发病率差异无统计学差异,男性CVA患者中13-30岁患病率较高,女性CVA患者中46-60岁患病率较高。结论 CVA是青岛市亚急性、慢性咳嗽最常见原因,临床医师应加强对本病的认识,早期诊断,规范治疗。  相似文献   

3.
Background and objective: The pathophysiology of cough variant asthma (CVA) is poorly understood. We compared bronchoconstriction‐triggered cough between CVA patients and normal control (NC) subjects. Methods: There were two protocols in the study. We measured bronchial responsiveness to methacholine (MCh) and counted the number of coughs in nine CVA patients and seven NC subjects (Study A). Using partial and full flow–volume curves, expiratory flow of the partial flow–volume curve at 40% above residual volume level (PEF40) and FEV1 were used to measure bronchoconstriction. Mild bronchoconstriction was defined as a 35% fall in PEF40 (PC35‐PEF40), and more severe bronchoconstriction as a 20% fall in FEV1 (PC20‐FEV1). In study B, the same measurements were obtained in six CVA patients before and after therapy. Results: In study A, more coughs were provoked at PC35‐PEF40 in CVA patients (median, 60 coughs/32 min post challenge; range, 12–135) than in NC subjects (median, 0/32 min; range, 0–13; P < 0.05). At PC20‐FEV1, more coughs were provoked in CVA patients (median, 60/32 min; range, 12–150) than in NC subjects (median, 20/32 min; range, 0–54; P < 0.05). In study B, the six CVA patients who underwent re‐examination after treatment had less coughs at PC35‐PEF40 (median, 3/32 min; range, 0–14) and PC20‐FEV1 (median, 13/32 min; range, 3–26) after therapy than before therapy (median, 54/32 min; range, 33–125 and 52/32 min, 45–96, respectively; P < 0.05). Conclusions: We identified heightened cough response to bronchoconstriction as a feature of CVA.  相似文献   

4.
OBJECTIVE: The aims of the present study were to examine the prevalence and clinical features of cough variant asthma (CVA) among patients with chronic and persistent cough at an outpatient clinic in Japan, and the efficacy of treatment with an inhaled corticosteroid. METHODOLOGY: This prospective study was conducted at a general internal medicine outpatient clinic in Japan over a 12-month period. CVA was diagnosed as chronic cough without wheezing or any apparent cause, that had persisted for more than 8 weeks, with a normal CXR and spirometry but with bronchial hyperresponsiveness to methacholine, and relief of cough after bronchodilator treatment. We also examined the effects of inhaled beclomethasone propionate on symptoms and differences in PEF between early morning and evening. RESULTS: Of 55 patients suffering from chronic cough, 23 satisfied the criteria for CVA. Their cough occurred more frequently at night and early in the morning. Early morning PEF was significantly lower than evening PEF with a mean variability of 11.5 +/- 4.1%. Treatment with beclomethasone propionate improved coughing and significantly increased early morning PEF, reducing variability to less than 10%. CONCLUSIONS: These findings suggest that CVA is most common among patients with chronic cough not due to any apparent cause. The efficacy of inhaled corticosteroid suggests that early intervention is effective in the treatment of CVA.  相似文献   

5.
This two-group prospective study evaluated the effect of anti-reflux surgery (fundoplication) on 24 patients with severe gastro-oesophageal reflux disease (GORD) and concomitant asthma (n=13) or chronic cough (n=11). Twenty-four hour oesophageal pH monitoring and lung function tests (FEV1, FVC) were done before and within 1 year after anti-reflux surgery. A diary was kept by the patient during the 4-week period prior to surgery and during 4-week periods 6 and 12 months postoperatively, with daily monitoring of peak expiratory flow rate, respiratory and reflux symptoms and medication. In non-asthmatic patients, coughing was reduced by 47% and 80% during the day and night, respectively, 12 months after surgery (P < 0.01). Concomitant hoarseness and expectoration were also significantly reduced (P<0.05). No effect on lung function was seen. In patients with asthma, small, non-significant reductions in asthma symptom scores and consumption of rescue medication were seen. Twenty-two patients were completely free from their GORD symptoms after surgery. In conclusion, anti-reflux surgery in patients with GORD had a more favourable effect on concomitant cough than concomitant asthma.  相似文献   

6.
韩淑慧 《临床肺科杂志》2013,18(7):1254-1255
目的通过对苏黄止咳胶囊治疗儿童咳嗽变异性哮喘的疗效进行观察。方法选取108例儿童咳嗽变异性哮喘者且按照1∶1比例将其分为两组,即常规治疗组(对照组)和苏黄止咳胶囊治疗组(试验组)、每组54例,同时对两组患儿临床治疗效果、中医症候改善效果、生活质量等内容进行观察且对所统计的数据加以分析。结果试验组患儿临床治疗受益率、中医症候改善总有效率高于对照组,P<0.05,临床症状改善时间较对照组缩短,P<0.05。结论苏黄止咳胶囊治疗儿童咳嗽变异性哮喘效果显著且安全可靠。  相似文献   

7.
33例咳嗽变异性哮喘的诊断分析   总被引:2,自引:1,他引:1  
目的探讨咳嗽变异性哮喘的诊断及治疗。方法对诊断为咳嗽变异性哮喘的33例患者进行回顾性分析。结论咳嗽变异性哮喘因缺乏典型哮喘的临床表现,常误诊为其它疾病,应重视其诊断与鉴别。  相似文献   

8.
咳嗽变异型哮喘26例临床分析   总被引:2,自引:2,他引:2  
刘洪 《临床肺科杂志》2007,12(8):803-803
目的了解咳嗽变异型哮喘的诊断和治疗。方法回顾性分析26例咳嗽变异型哮喘的临床特点,诊断要点和治疗效果。结论咳嗽变异型哮喘临床并非少见,但常易误诊造成病人延误治疗。  相似文献   

9.
10.
目的观察口服孟鲁司特钠(顺尔宁)治疗咳嗽变异性哮喘的效果。方法将156例咳嗽变异性哮喘患儿随机分为两组:治疗组84例,给予口服孟鲁司特钠治疗;对照组72例,给予布地奈德(普米克)及沙丁胺醇(万托林)吸入治疗。观察用药后1周、15天、1个月、3个月咳嗽消失的情况。结果对照组显效56例,有效11例,无效5例;治疗组显效68例,有效13例,无效3例,两组比较差异无统计学意义(U=0.2896,P〉0.05)。结论口服孟鲁司特钠与吸入布地奈德治疗咳嗽变异性哮喘效果相当,但使用方便。  相似文献   

11.
咳嗽变异型哮喘28例临床分析   总被引:1,自引:0,他引:1  
目的探讨咳嗽变异型哮喘的诊断和治疗。方法回顾性分析28例咳嗽变异型哮喘的临床特点,诊断要点和治疗效果。结果咳嗽变异型哮喘临床并不少见,但常易误诊造成延误治疗。结论提高对咳嗽变异性哮喘认识,结合支气管舒张试验等可做出诊断。  相似文献   

12.
目的探讨咳嗽变异型哮喘(CVA)的肺功能特点。方法将100例CVA患者的临床资料与80例典型哮喘患者和80例正常组进行对比分析。结果CVA患者肺通气功能高于哮喘患者,而低于正常组,差异有显著性(P〈0.05),CVA患者激发试验前后肺功能改变明显,存在可逆性改变。结论CVA患者气道存在可逆性阻塞,肺功能测定是行之有效的检测手段。  相似文献   

13.
咳嗽变异型哮喘46例临床研究   总被引:1,自引:1,他引:1  
目的探讨咳嗽变异型哮喘的诊断及治疗。方法对46例咳嗽变异型哮喘的患者进行分析。结果主要症状为慢性咳嗽,支气管舒张试验阳性,吸入支气管舒张剂及糖皮质激素治疗效果良好。结论该病临床上多见,但因临床表现不典型,易误诊,应提高对该病的认识。  相似文献   

14.
代育中  杨慧 《临床肺科杂志》2016,(12):2271-2273
目的观察苏黄止咳胶囊治疗儿童咳嗽变异性哮喘(CVA)的疗效。方法将150例CVA患儿随机分为两组,对照组(n=75)给予糖皮质激素吸入加β_2受体激动剂吸入,观察组(n=75)在此基础上给予苏黄止咳胶囊;比较两组患儿的疗效和不良反应。结果观察组的总有效率高于对照组(P0.05);两组患儿的血嗜酸粒细胞计数及血清IgE均较治疗前显著降低(P均0.05),但观察组的降低幅度明显优于对照组(P均0.05);两组患者在治疗期间均未见严重不良反应,观察组半年复发率较对照组明显降低(P0.05)。结论苏黄止咳胶囊联合布地奈德气雾剂治疗儿童CVA疗效确切。  相似文献   

15.
目的探讨布地耐德与福美特罗吸入治疗咳嗽变异性哮喘的临床疗效。方法40例确诊咳嗽变异性哮喘患者给予布地耐德与福美特罗吸入,观察咳嗽缓解情况。结果咳嗽症状3d后消失21例,1周后消失10例,6例1个月后消失,仅3例持续用药2个月后咳嗽症状消失。结论咳嗽变异性哮喘患者早期给予支气管扩张剂和激素吸入可明显缓解咳嗽症状。  相似文献   

16.
目的探讨呼吸道感染后咳嗽与咳嗽变异性哮喘患者痰炎症细胞的特点及其临床意义。方法收集呼吸道感染后咳嗽(Ⅰ组,22例)和咳嗽变异性哮喘(Ⅱ组,24例)患者痰或高渗盐水诱导痰,作瑞氏染色后细胞涂片,并在显微镜下细胞分类计数,测定其通气功能和乙酰甲胆硷吸入测定气道反应性。结果Ⅰ组和Ⅱ组痰液炎症细胞总数分别为8.22×10^9/L和8.94×10^9/L,两组比较无统计学意义(P〉0.05);而Ⅰ组嗜酸细胞和中性粒细胞的中位数分别为0.20%、5.88%,与Ⅱ组比较,两种细胞(分别为9.62%、2.48%)的组间比较差异均有显著性(P〈0.01)。Ⅱ组的气道反应性(支气管激发试验阳性100%,其PC20为1.24g/L)明显高于Ⅰ组(支气管激发试验阳性16.7%,且其PC10较高,为4.85g/L,P〈0.01)。咳嗽变异性哮喘组痰液嗜酸细胞与气道反应性指标PC10成呈显著负相关(r=-0.56,P〈0.01)。结论呼吸道感染后咳嗽与咳嗽变异性哮喘痰炎症细胞特点不同,痰中炎症细胞检查和气道反应性测定,可作为鉴别呼吸道感染后咳嗽与咳嗽变异性哮喘的一项参考指标。  相似文献   

17.
目的探讨儿童支气管哮喘、咳嗽变异性哮喘和急性支气管炎气道反应性特点及其临床价值,为临床诊断提供基础依据。方法回顾性分析2012年12月~2013年12月我院收治的以组胺为气道激发剂,采用气道反应性测定仪测定的40例支气管哮喘(A组)、40例咳嗽变异性哮喘(B组)及40例急性支气管炎(C组)儿童气道反应性变化及肺功能水平。结果 A组、B组和C组患儿肺功能指标FVC%、FEV1%、FEV1/FVC%、PEF%及MMEF%,两两比较差异无统计学意义(均P0.05);A组和B组患儿气道激发试验均为阳性,C组患儿气道激发试验阳性率为15.00%;3组患儿基础呼吸阻力(Rrscont)和基础呼吸传导率(Grscont)两两比较差异无统计学意义(均P0.05);3组患儿反应阈值(Dmin)和反应阈浓度(Cmin)两两比较差异有统计学意义(均P0.05)。结论气道反应性测定对不同呼吸系统疾病具有鉴别和指导治疗的作用,值得临床进一步推广使用。  相似文献   

18.
目的 咳嗽变异型哮喘(cough variant asthma,CVA)是慢性咳嗽的常见病因.本研究旨在应用Meta分析的方法评价呼出气一氧化氮(fractional exhaled nitric oxide,FeNO)检测对慢性咳嗽人群CVA诊断的有效性和准确性.方法 检索Embase、PubMed、Medline、Cochrane library、Web of science、百度学术、中国期刊网和万方数据库,全面收集FeNO在慢性咳嗽人群对CVA诊断的文献,检索时限均从建库至2016年8月.根据QUADAS-2量表的评价标准对文献进行质量评价.用Stata 14.0、RevMan 5.0软件对文献进行异质性分析,并计算合并的敏感性、特异性、阳性似然比、阴性似然比、诊断优势比和SROC曲线下面积.结果 共纳入文献5篇,涉及慢性咳嗽患者704例.FeNO检测诊断CVA合并的敏感度、特异度、阳性似然比、阴性似然比、诊断优势比、SROC曲线下面积分别为0.74 [95%可信区间(CI):0.69~0.79],0.85 (95% CI:0.81~0.88),4.73 (95%CI:3.70~6.05),0.31 (95% CI:0.26~0.38),14.84 (95%CI:10.11~21.79)和0.87 (95%CI:0.84~0.89).结论 FeNO对慢性咳嗽人群中CVA的诊断有较好的敏感度和特异度,可作为重要的诊断指标.  相似文献   

19.
目的 探讨孟鲁司特钠对咳嗽变异性哮喘患儿气管炎症的治疗效果.方法 以我院咳嗽变异性哮喘患儿98例为研究对象,按照患者是否使用孟鲁司特钠,将患儿分为观察组(49例)和对照组(49例),比较患儿在临床症状、肺功能和咳嗽变异性哮喘相关炎性因子水平之间的差异.结果 观察组患儿临床各指标水平优于对照组,其差异有统计学意义.结论孟鲁司特钠相较于传统长期吸入糖皮质治疗方法,对于小儿咳嗽变异性哮喘有更积极的治疗作用.  相似文献   

20.
Background and Aims: Chronic cough is associated with an enhanced excitability of airway cough receptors, possibly due to action of neurotrophins. The present study aimed to compare the neurotrophin levels between healthy subjects and patients with chronic cough and to analyze the factors associated with these levels. Methods: Serum and sputum levels of nerve growth factor (NGF), serum levels of brain‐derived neurotrophic factor (BDNF), and neurotrophin‐3 (NT‐3) were analyzed by enzyme immunoassay in 19 healthy subjects and 47 patients with chronic cough. In addition, cough sensitivity to hypertonic saline was assessed, cough diary was kept, Leicester Cough Questionnaire was filled in, peak flow was monitored and spirometry, skin prick tests, exhaled nitric oxide measurement and histamine challenge were performed. Results: The NGF levels did not differ between the healthy subjects and the patients with chronic cough and were not associated with any index describing cough severity. However, these levels in both serum (P = 0.01) and sputum (P = 0.025) samples were associated with asthma. There was a statistically significant association between serum and sputum NGF levels (R = 0.45, P = 0.026). The serum BDNF levels did not differ between the groups and were not associated with any of the background characteristics. The serum NT‐3 levels were below the detection limit in most subjects and therefore these data were not analyzed. Conclusions: Neither chronic cough nor its severity is associated with abnormal neurotrophin levels. High NGF levels among some patients with chronic cough may indicate a presence of asthma. Please cite this paper as: Koskela HO, Purokivi MK and Romppanen J. Neurotrophins in chronic cough: association with asthma but not with cough severity. The Clinical Respiratory Journal 2009; DOI:10.1111/j.1752‐699X.2009.00143.x.  相似文献   

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