Common causes of chronic cough and the diagnostic value of clinical symptoms / 中国综合临床

ABSTRACT

Objective To evaluate the common causes of chronic cough and the diagnostic value of clinical symptoms,and provide evidences for empirical treatment.Methods The causes of patients with chronic cough were evaluated by a validated systematic diagnostic protocol.The characteristics of the cough timing,characters,incentives and associated manifestations of chronic cough with different causes were compared.Results A total of 160 patients with at least 8 weeks of chronic cough and normal chest radiographswere recruited from the Department of respiratory diseases of Yichang Central Hospital between Jan.to Dec.2009.The most common causes of chronic cough were cough variant asthma (CVA,n =72,45％ ),upper airway cough syndrome ( UACS,n =54,33.75％ ),eosinophilic bronchitis ( EB,n =14,8.75％ ),gastroesophageal reflux-related chronic cough ( GERC,n =9,5.63％ ),other etiologies ( n =11,6.87％ ).Significant differences were observed in different etiological subtypes.The incidence of nocturnal cough in CVA was 52.8％ ( 38/72 ),significantly higher than others types ; URCS patients manifested more day coughs,with 70.2％ postnasal drip syndrome and significantly more cases had the history of nasal diseases compared with other types.The specificity of cough associated with meals in GERC were 66.7％,and the regurgitation associated symptom in GERC were77.8％,significantly higher than other types.However no special syndromes were observed in EB patients.Conclusion All kinds of chronic coughs have specific symptoms.The spectrum of causes and clinical features of chronic cough are important in the diagnostic procedure of chronic cough.