摘要
目的探讨不同年龄慢性咳嗽患者的病凶和针对性治疗的疗效。方法258例慢性咳嗽患者分为青年组145例和中老年组113例，采用中华医学会《咳嗽的诊断与治疗指南》对其病因进行分析，根据临床表现、辅助检查和特异性治疗效果综合判断，针对慢性咳嗽的病因给予特异性治疗，停药4周后判断疗效。结果青年组和中老年组患者中，最终病因明确者分别是136例（93．8％）和105例（92．9％）。青年组病因诊断前j位为咳嗽变异型哮喘（CVA）48例（29．09％）、上气道咳嗽综合征（UACS）39例（23．64％）和变应性咳嗽（AC）30例（18．18％），三者占慢性咳嗽病因的70．91％，其次是胃食管反流性咳嗽（GERC）、感冒后咳嗽等；中老年组病因诊断前三位为CVA43例（32．57％），GERC31例（23．48％）、UACS25例（18．94％）、三者占慢性咳嗽病因的75．0％，其次是血管紧张素转换酶抑制剂诱发的咳嗽、AC等。青年组和中老年组经特异性治疗后咳嗽明显减轻或消失分别为134例和104例，有效率分别为92．41％和92．03％，其余均为部分缓解，两组疗效比较。差异无统计学意义（P〉0．05）。结论不同年龄慢性咳嗽的常见病因不同，规范慢性咳嗽病因诊断程序对提高慢性咳嗽诊治水平有重要意义。
Objective To investigate the causes of chronic cough in different age group and assess the efficacy of specific therapy. Methods A total of 258 patients were divided as the young group （145） and the elderly group （113） whose cough duration more than eight weeks. They were diagnosed using a diagnostic protocol based on the Guideline on Diagnosis and Treatment of Chronic Cough established by China Medical. The etiological diagnosis was made according to clinical manifestations, lab examinations, and response to specific therapy. The effects were assessed after the drug withdraw for four weeks. Results The cause of chronic cough was confirmed in 136 （93.8%） and 105 patients （92.9%） in the young group and the elderly group respectively. The main causes in the young group included cough variant asthma （CVA） in 48 patients （29.09%）, upper airway cough syndrome （UACS） in 39 patients （23.64%）, atopic cough in 30 patients （18.18%）. The three causes accounted for the etiology of chronic cough in 70.91%, followed by gastro-esophageal reflux cough （GERC）, postinfectious cough （PIC）. however, the main causes in the elderly group included CVA in 43 patients （32.58%）, GERC in 31 patients （23.48%/00） ,UACS in 25 patients （18.94%）, the top three causes accounted for 75.0% of chronic cough in the elderly group patients, followed by the ACEI-induced cough, AC and so on. After specific therapy based on diagnosis, cough cured and alleviated in 134 patients （92.41%） in the young group and 104 patients （92.03%） in the elderly group respectively, the rest are partially alleviated. There is no significant difference in two groups （ P 〉0.05）. Conclusions The causes of chronic cough maybe variant in different age. Specific therapy is effective in majority of patients with chronic cough.
出处
《国际呼吸杂志》
2011年第23期1766-1769,共4页
International Journal of Respiration
关键词
慢性咳嗽
病因学
治疗
Chronic cough
Etiology
Treatment
