支气管激发试验在慢性咳嗽病因诊断中的运用价值

目的 探讨支气管激发试验(bronchial provocation test,BPT)在慢性咳嗽及咳嗽变异型哮喘(cough variant asthma,CVA)诊断中的应用价值.方法 对1 155例慢性咳嗽患者进行乙酰甲胆碱BPT,检测其气道高反应性.结果 1 155例慢性咳嗽患者中,各年龄组肺功能参数比较差异无统计学意义.BPT阳性584例,阴性571例,阳件率50.6%.确诊为CVA 547例;其余37例BPt阳性慢性咳嗽患者中25例为感染后咳嗽,12例为慢性支气管炎.BPT诊断CVA的特异度为93.6%.小于30岁年龄组CVA比例最高,占慢性咳嗽68.8%;≥60岁组CVA百分比最低,为23.5%.结论 CVA足慢性咳嗽的主要病因,对不明原因的慢性咳嗽患者应及时进行BPT,有助于早期明确诊断并施以正确治疗.

Etiological diagnosis utilization value of bronchial provocation test in patients with chronic cough

Objective To investigate the etiological diagnosis utilization value of bronchial provocation test(BPT) in patients with chronic cough variant asthrna(CVA).Methods BPT was performed to assess the bronchial responsiveness by inhaling methacholine in 1 155 patients with chronic cough.Results There was no significant difference of pulmonary function in different age groups.The positive rate of BPT was 50.6 (584/1 155,285 males,299 females),in those patients with positive result,547 patients were diagnosed as CVA,25 patients as post-infection cough,and 12 patients as chronic bronchitis.BPT specificity was 93.9 %.The population under 30 years old had the highest CVA diagnostic rate of 68.8% and those over 60 years old had the lowest diagnostic rate of 23.5%.The two groups had significant difference when compared with other age groups respectively.Conclusions CVA is the main cause of chronic cough.BPT is a simple and effective method in the diagnosis of CVA at early stage.