咳嗽变异型哮喘76例临床研究.docVIP

咳嗽变异型哮喘76例临床研究 　　[摘要] 目的 提高医务人员对咳嗽变异型哮喘（cough variation asthma， CVA）的认识，减少误诊误治。 方法 回顾性分析76例CVA的临床资料，总结其特点。 结果 本病有以下特点：（1）春秋及冬季多发；（2）咳嗽多为阵发性干咳，以夜间及凌晨为著，运动、吸入冷空气或异味后诱发或加重；（3）多有过敏性鼻炎或荨麻疹等过敏史；（4）胸部查体及胸片多无明显异常；（5）支气管舒张试验阳性；（6）嗜酸性粒细胞常增高；（7）抗生素及止咳药治疗无效，而糖皮质激素和支气管扩张剂治疗有效。 结论 CVA易被误诊为上呼吸道感染等疾病，但有一定的临床特点，对临床上以夜间和清晨为主的反复咳嗽，查体及胸片无明显异常，止咳药及抗生素治疗无效，有过敏性鼻炎或荨麻疹等过敏史者，应考虑本病，可用糖皮质激素和支气管扩张剂进行试验性治疗，有条件的再结合肺功能测定等，大多可做出到早期诊断。 [关键词]哮喘；咳嗽；变异型；诊断；治疗 [中图分类号] R562.2+5 [文献标识码] B [文章编号] 2095-0616（2013）13-201-02 Clinical analysis of 76 cases of cough variation asthma ZHANG Shengquan Outpatient Clinic，North District of 401 Hospital of PLA，Qingdao 266100，China [Abstract] Objective To increase the knowledge about cough variation asthma（CVA），and decreasing the mistake in diagnosis and treatment of CVA. Methods The clinical data of 76 cases of CVA were analysed retrospectively， and the features were summarized. Results The features of CVA were as follow：（1）The CVA were often occured in spring， autumn and winter.（2）Cough was often paroxysmal with no sputum. It was serious in the midnight and daybreak.It was caused or becoming more serious when the patient was exercising or inhaling cold air and peculiar smell.（3）The most patients had allergic history of suffering from allergic rhinitis or urticaria. （4）The physical examination and X-ray of chest were normal for most patients.（5）The bronchodilation test result was positive.（6）The amount of esoino was often more.（7）It had no effect to the treatment with antibiotics and drugs for cough.but it was effect to the treatment with glucocorticoid and bronchodilator. Conclusion CVA was often diagnosed as upper respiratory infection and so on.It should be diagnosed as CVA when patient had the features as follow：Cough became serious in the midnight and daybreak.The physical examination and X-ray of chest were normal.It had no effect to the treatment with antibiotics and drugs for cough. The patient had allergic history of suffering from allergic r