目的 探討重慶地區(qū)慢性咳嗽的病因和針對(duì)性治療的療效。方法 采用中華醫(yī)學(xué)會(huì)和美國(guó)胸科醫(yī)師學(xué)會(huì)的慢性咳嗽診治指南, 對(duì)233 例慢性咳嗽患者的病因進(jìn)行分析, 根據(jù)臨床表現(xiàn)、輔助檢查和特異性治療效果綜合判斷; 針對(duì)慢性咳嗽的病因給予特異性治療, 停藥4 周后判斷療效。結(jié)果 233 例患者中明確診斷216 例( 92. 7% ) , 病因未明者17 例( 7. 3% ) 。216 例病因明確者中, 單一病因163 例( 75. 45% ) , 雙重病因44 例( 20. 37%) , 三重以上病因9 例( 4. 10%) 。病因包括上氣道咳嗽綜合征( UACS) 127 例( 44. 4% ) , 咳嗽變異性哮喘( CVA) 73 例( 25. 5% ) , 胃食管反流性咳嗽( GERC) 26 例( 9. 1% ) , 感染后咳嗽6 例( 2. 1% ) , 血管緊張素轉(zhuǎn)換酶抑制劑類藥物( ACEI) 性咳嗽6例( 2. 1% ) , 變應(yīng)性咳嗽( AC) 5 例次( 1. 7% ) , 慢性支氣管炎3 例次( 1. 0% ) , 其他病因累計(jì)24 例( 8. 4% ) 。慢性咳嗽前五位病因?yàn)閁ACS、CVA、GERC、感染后咳嗽及ACEI 相關(guān)性咳嗽。216 例明確診斷的患者經(jīng)特異性治療后, 59 例( 25. 3% ) 患者咳嗽痊愈, 114 例( 49. 3% ) 患者咳嗽緩解, 40 例( 17. 1% ) 無(wú)效。結(jié)論 UACS、CVA 和GERC 是重慶地區(qū)慢性咳嗽的常見(jiàn)原因, 多數(shù)患者經(jīng)針對(duì)性治
療后癥狀能夠緩解
引用本文： 曹國(guó)強(qiáng) ,程曉明,戴曉天,熊瑋,陳虹,粟毅,王導(dǎo)新,蔣幼凡,王長(zhǎng)征. 重慶地區(qū)慢性咳嗽病因的多中心研究. 中國(guó)呼吸與危重監(jiān)護(hù)雜志, 2009, 09(6): 565-568. doi: 復(fù)制
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| 5. | 中華醫(yī)學(xué)會(huì)呼吸病學(xué)分會(huì)哮喘學(xué)組. 咳嗽的診斷與治療指南( 草案) . 中華結(jié)核和呼吸雜志, 2005, 28: 738-744. |
| 6. | Irwin RS, Baumann MH, Bolser DC. et al. Diagnosis and Management of Cough Executive Summary: ACCP Evidence-Based Clinical Practice Guidelines. Chest, 2006, 129: 1S-23S. |
| 7. | Pratter MR. Chronic Upper Airway Cough Syndrome Secondary to Rhinosinus Diseases ( Previously Referred to as Postnasal Drip Syndrome) : ACCP Evidence-Based Clinical Practice Guidelines.Chest, 2006, 129: 63S-71S. |
| 8. | Morice AH. Chronic cough: Epidemiology. Chron Respir Dis, 2008 ,5: 43-47. |
| 9. | Irwin RS. Introduction to the diagnosis and management of cough:ACCP evidence-base clinical practice guidelines. Chest, 2006, 129 :25S-27S. |
| 10. | Pratter MR. Overview of Common Causes of Chronic Cough: ACCP evidence-based clinical practice guidelines. Chest, 2006 , 129: 59S-62S. |
| 11. | Kastelik JA, Aziz I, Ojoo JC, et al. Investigation and management of chronic cough using a probability-based algorithm. Eur Respir J,2005, 25: 235-243. |
| 12. | 何權(quán)瀛. 對(duì)于慢性咳嗽診斷治療的幾點(diǎn)考慮. 中國(guó)呼吸與危重監(jiān)護(hù)雜志, 2008, 7, 1-2. |
- 1. Pratter MR. Overview of Common Causes of Chronic Cough: ACCP Evidence-Based Clinical Practice Guidelines. Chest, 2006 , 129 :59S-62S.
- 2. 賴克方, 陳如沖, 劉春麗, 等. 不明原因慢性咳嗽的病因分布及診斷程序的建立. 中華結(jié)核和呼吸雜志, 2006, 29: 96-99.
- 3. 王志虹, 林江濤, 李勇, 等. 慢性咳嗽的病因診斷及治療效果. 中國(guó)醫(yī)學(xué)科學(xué)院學(xué)報(bào), 2007, 29: 665-668.
- 4. 馬洪明, 朱禮星, 賴克方, 等. 不明原因慢性咳嗽的診斷探討. 中華結(jié)核和呼吸雜志, 2003, 26: 675-678.
- 5. 中華醫(yī)學(xué)會(huì)呼吸病學(xué)分會(huì)哮喘學(xué)組. 咳嗽的診斷與治療指南( 草案) . 中華結(jié)核和呼吸雜志, 2005, 28: 738-744.
- 6. Irwin RS, Baumann MH, Bolser DC. et al. Diagnosis and Management of Cough Executive Summary: ACCP Evidence-Based Clinical Practice Guidelines. Chest, 2006, 129: 1S-23S.
- 7. Pratter MR. Chronic Upper Airway Cough Syndrome Secondary to Rhinosinus Diseases ( Previously Referred to as Postnasal Drip Syndrome) : ACCP Evidence-Based Clinical Practice Guidelines.Chest, 2006, 129: 63S-71S.
- 8. Morice AH. Chronic cough: Epidemiology. Chron Respir Dis, 2008 ,5: 43-47.
- 9. Irwin RS. Introduction to the diagnosis and management of cough:ACCP evidence-base clinical practice guidelines. Chest, 2006, 129 :25S-27S.
- 10. Pratter MR. Overview of Common Causes of Chronic Cough: ACCP evidence-based clinical practice guidelines. Chest, 2006 , 129: 59S-62S.
- 11. Kastelik JA, Aziz I, Ojoo JC, et al. Investigation and management of chronic cough using a probability-based algorithm. Eur Respir J,2005, 25: 235-243.
- 12. 何權(quán)瀛. 對(duì)于慢性咳嗽診斷治療的幾點(diǎn)考慮. 中國(guó)呼吸與危重監(jiān)護(hù)雜志, 2008, 7, 1-2.