伴有咽喉炎样表现的慢性咳嗽的病因分布

目的调查伴有咽喉炎样表现的慢性咳嗽患者的病因分布。方法收集2002年12月至2010年3月广州呼吸疾病研究所门诊伴有咽喉炎样表现的慢性咳嗽患者。按慢性咳嗽病因诊断程序进行病因诊断,详细询问病史和查体,进行通气功能＋支气管激发试验、诱导痰细胞学检查、食管24小时pH值监测等检查,结合治疗反应确定病因诊断。结果共纳入伴有咽炎样表现的慢性咳嗽患者326例,男176例,女150例;平均年龄（41±13）岁,病程中位数为24个月（2～480个月）。最后明确诊断上气道咳嗽综合征或鼻后滴流综合征73例（23.31%）,咳嗽变异性哮喘61例（18.71%）,嗜酸细胞性支气管炎70例（22.47%）,胃食管反流性咳嗽54例（16.56%）,变应性咳嗽48例（14.72%）,其他病因28例（8.59%）,病因不明12例（3.68%）。伴发咽喉炎样表现的各个常见病因之间比例无显著差异。结论在伴有咽喉炎样表现的慢性咳嗽患者中,上气道咳嗽综合征的比例与其他病因的比例无显著性差异,表明单纯的咽喉炎样表现对上气道咳嗽综合征没有诊断价值。

Etiological Diagnosis of Chronic Cough with Pharyngitis-Like Manifestations

Objective To investigate the etiological diagnosis of chronic cough with pharyngitis-like manifestations.Methods Patients with chronic cough and pharyngitis-like manifestations were recruited from Outpatient Department of Guangzhou Institute of Respiratory Diseases between December 2002 to March 2010.The causes of chronic cough were investigated using a well-established diagnostic protocol,including histories and physical examination,pulmonary function tests,induced sputum cytology,24-h esophageal pH monitoring,etc.The final diagnosis depended on clinical manifestations,examination findings,and a successful response to therapy.Results 326 patients with chronic cough and pharyngitis-like manifestations were included in the study with a median duration of 24（2～480） months,a mean age of 41±13 years.The causes of chronic cough were identified as follows： post nasal drip syndrome or upper airway cough syndrome in 73 cases（23.31%）,cough variant asthma in 61 cases（18.71%）,eosinophilic bronchitis in 70 cases（22.47%）,gastroesophageal refluxinduced cough in 54 cases（16.56%）,atopic cough in 48 cases（14.72%）,and others in 40 cases（12.27%）.There is no significant difference in percentage of common causes of chronic cough（P0.05）.Conclusion The proportions of upper airway syndrome and other common causes are similar in chronic cough with pharyngitis-like manifestatioins,which suggest pharyngitis-like manifestations are not specific for diagnosis of upper airway cough syndrome.