运动-组胺激发试验对咳嗽变异型哮喘的诊断价值

目的探讨运动-组胺激发试验(EHIA)对咳嗽变异型哮喘(CVA)的诊断价值.方法对22例CVA患者、10例慢性支气管炎(气道高反应性,AHR)患者进行运动-组胺激发试验,并与单纯运动激发试验进行比较.结果运动-组胺激发试验对两组患者的诊断阳性率差异有显著性,似乎表明EHIA可区别哮喘和慢性支气管炎对组胺的AHR.结论运动-组胺激发试验对提高咳嗽变异型哮喘的诊断具有应用价值.     

运动—组胺激发试验对咳嗽变异型哮喘的诊断价值

目的 探讨运动-组胺激发试验(EHIA)对咳嗽变异型哮喘(CVA)的诊断价值．方法 对22例CVA患者、10例慢性支气管炎(气道高反应性，AHR)患者进行运动-组胺激发试验，并与单纯运动激发试验进行比较．结果 运动-组胺激发试验对两组患者的诊断阳性率差异有显著性，似乎表明EHIA可区别哮喘和慢性支气管炎对组胺的AHR．结论 运动-组胺激发试验对提高咳嗽变异型哮喘的诊断具有应用价值．     

运动-组胺激发试验对提高支气管哮喘诊断价值的研究

目的　探讨运动 -组胺激发试验 (EHIA)对支气管哮喘的诊断价值 .方法　对 2 0例健康者、118例支气管哮喘、2 2例过敏性鼻炎、2 4例慢性支气管炎患者进行运动 -组胺激发试验 ,并与单纯运动激发试验及组胺激发试验进行比较 .结果　显示运动 -组胺激发试验对哮喘患者的诊断阳性率达 97.4%、特异性 10 0 % ,且EHIA阳性所吸入的组胺量也反映了哮喘患者非特异性气道高反应性 .结论　运动 -组胺激发试验对提高早期及非典型支气管哮喘的确诊具有实用价值     

藜草花粉过敏与支气管哮喘的研究

为了确定藜草花粉过敏原对哮喘患者的致敏作用。对外源性哮喘患者用藜草花粉过敏原进行了皮肤挑刺试验（SPT）和支气管激发试验（BPT）。结果藜草花粉SPT阳性者为28.2％,18例BPT阳性者中,14例出现哮鸣音。藜草花粉BPT与SPT的符合率为85％。提示藜草花粉过敏原是我国哮喘患者的一个重要吸入性过敏原。     

运动—组胺激发试验对提高支气管哮喘诊断 …

目的 探讨运动－组胺激发试验（ＥＨＩＡ）对支气管哮喘的诊断价值。方法 对２０例健康者、１１８例支气管哮喘、２２例过敏性鼻炎、２４例慢性支气管炎患者进行运动－组胺激发试验，并与单纯运动激发试验及组胺激发试验进行比较。结果 显示运动－组胺激发试验对哮喘患者的诊断阳性率达９７．４％，特异性１００％，且ＥＨＩＡ阳性所吸入的组胺量也反映了哮喘患者非特异性气道高反应性。结论 运动－组胺激发试验对提高早期及非典     

吸烟致气道炎症反应早期诊断方法的探讨

目的 寻找临床上简便易行、可靠的早期诊断吸烟致气道炎症的方法.方法 检测了51例健康吸烟者与46例健康不吸烟者支气管肺泡灌洗液(BALF),并以BALF中细胞计数绝时值将炎症程度分为Ⅰ、Ⅱ、Ⅲ度;同时进行乙酰甲胆碱(Mch)支气管激发试验与24h最大呼气流量(PEF)测定;结果①51例健康吸烟者BALF细胞计数绝对值为(2.3～47.2)×108/L,其炎症分度为Ⅰ度16例、Ⅱ度22例、Ⅲ度13例.46例健康不吸烟者炎症分度均为Ⅰ度.②Mch支气管激发试验51例健康吸烟者阳性率64.7%.(Ⅰ度50%、Ⅱ68.2%、Ⅲ度76.9%),46例健康不吸烟阳性率15%.③24h-PEF变异值异常率为62.7%(Ⅰ度37.5%、Ⅱ72.7%、Ⅲ度76.7%).以结果与BALF炎症程度的相关性较好.结论 本文方法可较好地反映吸烟致气道炎症的严重程度,Mch支气管激发试验与PEF测定可作为吸烟气道炎症早期诊断的无创性指标之一.     

70 例慢性咳嗽患者的病因分析

目的 总结慢性咳嗽的诊断体会.方法 按照 Irwin 小组提出的慢性咳嗽解剖诊断程序分析2003年7月至2007年7月我院就诊的70例慢性咳嗽患者临床资料.结果 70例慢性咳嗽患者中,哮喘占24.5%,鼻后滴漏综合症占20.8%,胃食管反流病占17%,心功能不全占 15.1%,因服用转化酶抑制剂类降压药致咳11.3%,支气管内膜结核占3.8%,肿瘤5.7%,声带息肉1.9%.结论 慢性咳嗽病因复杂,临床医生要重视慢性咳嗽的临床诊治.     

89例小儿慢性咳嗽变应原检测的临床意义

目的探讨变应原与小儿慢性咳嗽的相互关系。方法对89例慢性咳嗽患儿及30例健康儿童,选择常见的吸入性变应原10种,食入性变应原10种进行皮肤点刺试验,部位选择前臂屈侧。结果89例慢性咳嗽患儿皮肤点刺试验阳性49例,阳性率54.9%。30例健康儿童皮肤点刺试验阳性8例,阳性率26.6%。两组经统计学处理有显著差异（P〈0.01）。结论慢性咳嗽与变应原关系密切,咳嗽迁延不愈可用变应原检测作为病因辅助诊断,以便避免过敏原的刺激减轻咳嗽症状。     

咳嗽变异型哮喘52例临床分析

目的提高对咳嗽变异型哮喘的认识,进一步减少临床上的误诊及误治.方法通过对52例变异性哮喘临床病例进行回顾性分析,寻找误诊原因.结果在确诊之前有38例患者被临床误诊,其中14例误诊为急性支气管炎,15例误诊为上呼吸道感染,5例误诊为慢性支气管炎,4例误诊为感冒后咳嗽.结论嗽变异型哮喘是引起慢性咳嗽的常见原因,熟悉和掌握其发病机制是提高减少误诊的关键,对反复大量应用抗生素无效者,应重点怀疑此病,并早期试用支气管扩张剂和糖皮质激素,有条件者尽可能做肺功能测定及支气管激发/舒张试验,以协助诊断.     

慢性咳嗽患者咳嗽敏感性的影响因素

目的探讨慢性咳嗽患者咳嗽敏感性的影响因素.方法按照慢性咳嗽病因诊断程序,人选并诊断慢性咳嗽患者.通过辣椒素咳嗽激发试验测定慢性咳嗽患者(治疗前)的气道咳嗽敏感性,以最先诱发5次或以上咳嗽的辣椒素溶液浓度(C5)的对数作为咳嗽阈值.分析咳嗽阈值与咳嗽积分、年龄、性别、病程、肺通气功能与诱导痰炎性细胞分类间的相关性.结果入选并获得明确诊断的不同病因慢性咳嗽患者共计150例.单因素相关分析显示,慢性咳嗽患者的咳嗽阈值与日间咳嗽积分、性别、年龄、咳嗽病程及诱导痰嗜酸细胞百分比有相关,r分别为-0.175、-0.305、-0.297、-0.238及0.173,P均<0.05;咳嗽阈值与夜间咳嗽积分、痰中性粒细胞百分比、痰巨噬细胞百分比、痰淋巴细胞百分比及肺通气功能[第1秒用力呼气容积占预计值的百分比(FEV1/pred%)、用力呼气中段流速占预计值的百分比(MMEF/pred%)]均不相关,P均>0.05.多元线性回归分析显示,咳嗽阈值仅与性别、咳嗽病程有关(P均<0.01).结论咳嗽敏感性与咳嗽症状积分反映咳嗽程度的不同特征,性别与咳嗽病程可能影响慢性咳嗽患者的咳嗽敏感性.     

Cough motor mechanisms

Cough is a defensive airway mechanisms which involves the sequential activation of several laryngeal and respiratory muscles in the generation of the typical four-phase motor pattern. Activation of such muscles can be considered to represent the "primary" cough motor mechanism, and its functional significance, although complex, appears to be fairly well established. Nonetheless, the outflows of cough are numerous, and may additionally involve the reflex or mechanical activation of other respiratory and non-respiratory motor systems. These additional, or "secondary", outflows of cough can mainly be regarded as being involved in either enhancing the defensive function of cough, or opposing the possible noxious effects exerted by the mechanical stresses of coughing. In addition, both the primary and secondary cough motor mechanisms are known to play multiple functional roles, thus considerably complicating the cough panorama. Finally, some of the secondary cough motor responses, such as the changes in the pattern of breathing, seem to be devoid of any favourable action and their functional meaning, if any, is not fully understood. Although it is well known that all patterns of cough can be produced voluntarily, the extent to which also volitional cough is accompanied by an array of motor responses similar to that of reflex cough remains to be elucidated.     

SLeuthing Tuberculous Cough

正Cough, a hallmark of tuberculosis, transmits the disease. Ruhl et al. find that a Mycobacterium tuberculosis(Mtb)-specific lipid, SL-1, stimulates human nociceptive neurons and makes guinea pigs cough. Mtb extract, but not SL-1, also stimulates non-nociceptive neurons that participate in the cough reflex, suggesting additional cough-inducing mechanisms.     

Gabapentin for Chronic Refractory Cancer Cough

Vagal sensory neuropathy or vagal hypersensitivity has been implicated in the pathophysiology of chronic cough. Earlier reports have shown gabapentin to be effective in sensory laryngeal neuropathy and symptom conditions that have a proven neural origin. We present a case report of a patient with chronic refractory cough due to a soft tissue mass in the lung that caused compression of the mediastinal structures. The patient was successfully treated with gabapentin with reduction in the cough intensity, duration, and frequency.     

Cough determinants in patients with neuromuscular disease

Neuromuscular disease leads to cough impairment. Cough augmentation can be achieved by mechanical insufflation (MI) or manually assisted coughing (MAC). Many studies have compared these two methods, but few have evaluated them in combination. In 155 neuromuscular patients, we assessed determinants of peak cough flow (PCF) using stepwise correlation. Maximal inspiratory capacity contributed 44% of the variance (p<0.001), expiratory reserve volume 13%, and maximal expiratory pressure 2%. Thus, augmenting inspiration seems crucial. However, parameters dependent on expiratory muscles independently influence PCF. We measured vital capacity and PCF in 10 neuromuscular patients during cough augmentation by MI, MAC, or both. MI or MAC significantly improved VC and PCF (p<0.01) as compared to the basal condition and VC and PCF were higher during MI plus MAC than during MAC or MI alone (p<0.01). In conclusion, combining MAC and MI is useful for improving cough in neuromuscular patients.