上气道咳嗽综合征病因的初步研究

目的研究上气道咳嗽综合征(UACS)的临床特征及其与上气道疾病、咳嗽变异性哮喘(CVA)和胃食管反流性疾病(GERD)的关联,为临床诊治提供帮助。方法 92例慢性咳嗽并同时有咽部症状和体征的患者纳入本研究。进行相关病史采集及支气管激发试验后,根据针对性治疗结果进行相关疗效评价及病因学分析。结果对疑为CVA的49例患者行支气管激发试验。其阳性率为28.6%(14/49),占全部病例数的15.2%(14/92)。18.5%(17/92)的患者有慢性胃炎病史或合并胃食管反流症状,其中部分患者抗胃食管反流治疗有效。有鼻炎/鼻窦炎病史和/或症状的患者仅占全部病例的33.7%(31/92)。51.1%(47/92)的患者仅有单纯的慢性咽部症状和体征。结论 UACS的病因不只与鼻炎/鼻窦炎有关,慢性咳嗽患者的"慢性咽炎"表现既可能是继发于慢性鼻炎/鼻窦炎的鼻后滴流和胃食管反流的结果,也可能是独立的慢性咳嗽病因。

A Preliminary Study on Etiology of Upper Airway Cough Syndrome

Objective To investigate the clinical characteristics of upper airway cough syndrome（UACS） and the relationship of UACS with upper airway diseases,cough variant asthma（CVA）,and gastroesophageal reflux disease（GERD）.Methods 92 subjects with chronic cough and throat symptoms and signs were included in the study.The medical records were collected from all subjects,and 49 subjects suspected for CVA undertook bronchial provocation test.Then the efficacy was evaluated and etiology were analyzed based on the efficacy of targeted treatment.Results Bronchial provocation test yielded positive results in 14 subjects suspected of CVA,accounting for 15.2% of all cases（14/92）.18.5%（17/92） of patients had a history of chronic gastritis or combined symptoms of GERD,of whom anti-gastroesophageal reflux treatment was effective.The patients with rhinitis,sinusitis history and/or symptoms accounted for 33.7% of cases（31 cases）.51.1%（47/92） of patients had only signs and symptoms of chronic pharyngitis.Conclusions UACS is not only due to the rhinitis and/or sinusitis but also chronic pharyngitis.Chronic pharyngitis may be secondary to chronic rhinitis/sinusitis with post nasal drip and gastroesophageal reflux,also may be an independent cause of chronic cough.