慢性干咳伴有气道高反应性即是咳嗽变异性哮喘吗？

目的评价气道反应性测定在咳嗽变异性哮喘（ＣＶＡ）诊断中的价值。方法１２４例慢性干咳患者经气道反应性测定后，分为咳嗽气道高反应阳性组（ＣＢＨ－Ｐ组）３５例，咳嗽气道高反应阴性组（ＣＢＨ－Ｎ组）３３例。观察常规肺功能、抗原皮肤点刺试验阳性率、血嗜酸性粒细胞计数、血ＩｇＥ水平、泼尼松试验阳性率并随访２年后发展成典型哮喘例数。结果３５例ＣＢＨ－Ｐ组一秒钟用力呼气容积占用力肺活量比值（ＦＥＶ１％）为７４±１０（Ｐ＜０．０１），３３例ＣＢＨ－Ｎ组为８３±１０（Ｐ＜０．０５）。抗原皮肤点刺试验阳性率ＣＢＨ－Ｐ组为５１％，ＣＢＨ－Ｎ组为１２％；血嗜酸性粒细胞计数ＣＢＨ－Ｐ组为０．５±０．１×１０９／Ｌ，ＣＢＨ－Ｎ组为０．３±０．１×１０９／Ｌ；泼尼松试验阳性率ＣＢＨ－Ｐ组为８３％，ＣＢＨ－Ｎ组为１５％。随访２年后发展成典型哮喘例数中ＣＢＨ－Ｐ组有１６例发展成典型哮喘。在ＣＢＨ－Ｐ组中发展成典型哮喘与未发展成典型哮喘患者在皮肤抗原点刺试验阳性率、常规肺功能、反应阈值（Ｄｍｉｎ）及致喘阈值（Ｄｃｗ／Ｄｍｉｎ）等方面差异均无显著性。结论气道反应性测定是诊断ＣＶＡ的重要依据，但不是唯一的诊断标准，还应结合其它临床资料综合判断

Will chronic nonproductive cough with bronchial hyperresponsiveness be cough variant asthma?

Objective The clinical characteristics of the patients suffered from chronic nonproductive cough with bronchial hyperresponsiveness were analyzed, so as to evaluate the value of measurement of bronchial responsiveness in diagnosis of cough variant asthma (CVA). Method 124 patients with chronic nonproductive cough were divided into two groups after the measurement of bronchial responsiveness: cough bronchial hyperresponsiveness positive group (CBH P, n =35) and cough bronchial hyperresponsiveness negative group (CBH N, n =33). Routine pulmonary function, positive rate of antigen skin pitting lest, count of blood eosinophil cells, level of blood IgE, positive rate of prednisone test and the number of development of classical asthma in two year following up were studied. Result The percentage of FEV1.0 in group CBH P was significantly lower than in group CBH N, but antigen skin pitting test, count of blood eosinophil cells, prednisone test and the number of development of classic asthma in two year following up were all higher than in the latter group. In group CBH P, there was no significant difference in positive rate of antigen skin pitting test, routine pulmonary function, reacting threshold(Dmin) and wheezing threshold (DCW/Dmin) between the patients who developed classic asthma and those who did not. Conclusion The measurement of bronchial responsiveness is important for the diagnosis of CVA, but it is not the only diagnostic criteria and should be combined with other clinical data.