ABSTRACT
Objective To constitute a correlation with the subjective indicators by investigation of the causes and clinical features in patients with chronic cough.Methods Totally 100 patients with chronic cough were recruited followed a diagnostic program.Airway responsiveness[by methacholine challenge test (MCT)],Leicester cough questionnaire(LCQ),visual analogue scale(VAS),cough score,age,gender and disease duration were all recorded for analysis.Results The top five causes of chronic cough in these patients were variant asthma,post infectious cough,atopic cough,eosinophilic bronchitis and upper airway cough syndrome.LCQ total score was negatively correlated with age and the VAS score(r=-0.239 and -0.470 respectively,all P0.05)and no correlation was found with BMI(r=-0.029,P>0.05).The physiological and psychological field score in female patients significantly reduced(t=2.174,1.990,P<0.05),and LCQ total score of MCT positive patients obviously reduced than negative ones(t=-2.22,P<0.05).After the treatment of two weeks,LCQ three component field and total score could be improved significantly(all P<0.01).Conclusion Gender and age may have some impact on the quality of life in patients with chronic cough.LCQ,VAS and cough score should be used to assess cough severity and evaluate therapeutic effect in patients with chronic cough.
ABSTRACT
Objective Preliminary study of the cough reflex sensitivity test in chronic cough patients with different gender,disease duration and causes to evaluate the clinical diagnostic significance of the test and further provide some information for the treatment of chronic cough.Methods Totally 108 chronic cough patients in our hospital were enrolled in the study with the final diagnosis of upper airway cough syndrome(UACS),cough variant asthma(CVA)and gastroesophageal reflux cough(GERC).They all went through the cough reflex sensitivity test and the retrospective analysis of the results was made.Results In 108 patients with chronic cough(76 UACS,19 CVA and 13 GERC),lgC5 was significantly slower in the female(1.80)than the male(2.40,P<0.05)and in the patients with cough duration over 12 months(1.80)than those with cough duration under 12 months(2.40,P<0.05).Cough sensitivity in patients with different causes was significantly different(P<0.05)with lower lgC5 in GERC patients(1.49)than CVA (2.40,P<0.05)and UACS(2.40,P<0.05)patients.Conclusion Cough sensitivity is different in chronic cough patients with different gender,disease duration and causes.Cough reflex sensitivity test is of great value in the etiology diagnosis of chronic cough.
ABSTRACT
ObjectiveTo investigate the characteristics of gastroesophageal reflux disease (GERD) with chronic cough by the results of combined multichannel intraluminal impedance and high-resolution manometry (MII-HRM) procedure and 24-hour muhichannel intraluminal impedance combined pH (MII pH) monitoring.Methods From March 2010 to November 2010,consecutive patients of GERD with chronic cough (more than 8 weeks) admitted to Beijing Chaoyang Hospital of Capital Medical University underwent 24-hour MII-pH monitoring and MII-HRM procedure with symptom association probability(SAP) over 95％.Data of lower esophageal sphincter (LES) pressure,LES relaxation,LES residual pressure,esophageal body peristalsis function and swallow bolus transit (liquid/viscous) was collected and the result of 24-hour MII-pH monitoring was analysed by the computer software containing reflux episode activity(acid/nonacid,upright/recumbent),proximal extent,acid exposure and mean acid/bolus clearance time.Seventeen patients of GERD with typical reflux symptom were selected as the control group.ResultsComparing with patients of GERD with typical reflux symptom,patients of GERD with chronic cough showeddecreased upper esophageal sphincter pressure (UESP) [( 122.55 ± 60.48 )mm Hg vs ( 86.37 ± 41.35 ) mm Hg,P ＜ 0.05,1 mm Hg =0.133 kPa ],higher percentage of abnormality peristalsis [(9.47 ± 15.63 ) ％ vs ( 22.16 ± 17.45 ) ％,P ＜ 0.05 ],degraded esophagus transmittability of liquid substance [( 88.82 ± 12.23) ％ vs ( 71.68 ± 23.06 ) ％,P ＜ 0.05 ],more reflux episode activity ( acid/nonacid ) in supine position and proximal reflux episode (nonacid) in supine position (P ＜ 0.05 )and longer mean bolus clearance time( P ＜ 0.05 ).Conclusion Decrease of the UESP,increase of the reflux episode activity (acid/nonacid) in supine position and proximal reflux episode (nonacid) in supine position,lengthened mean bolus clearance time in supine position and the degraded esophagus clearance ability may all correlated with the pathogenesy of GERD with chronic cough.