哮喘联盟

   摘要
   慢性痰咳或湿咳是成人呼吸门诊患者常见的主诉。大多数综述与指南表明：痰咳与干咳的病因相同，因此，诊断方法也应相同。我们建议对于痰咳患者应采用一种不同的诊断方法，这种诊断方法关注于疾病的最可能的病因。本篇综述旨在简要总结许多与慢性痰咳相关疾病的流行病学、临床特征、病理生理和治疗，从而有利于帮助遭受慢性痰咳痛苦的患者制定决策。涉及的疾病包括支气管扩张、慢性支气管炎、哮喘、嗜酸粒细胞性支气管炎和免疫缺陷。此外，对于对低剂量大环内酯类药物治疗有良好反应的特发性慢性痰咳患者，我们建议使用迁延性细菌性支气管炎（PBB）儿科诊断的成人版本。

 

（苏欣 审校）
Respir Med. 2015 Jul 6. pii:S0954-6111(15)30001-9.doi:10.1016/j.rmed.2015.05.020. [Epub ahead of print]

 

Causes of chronic productive cough: An approach to management.
 

Martin MJ1, Harrison TW2.
 

Abstract
A chronic 'productive' or 'wet' cough is a common presenting complaint for patients attending the adult respiratory clinic. Most reviews and guidelines suggest that the causes of a productive cough are the same as those of a non-productive cough and as such the same diagnostic pathway should be followed. We suggest a different diagnostic approach for patients with a productive cough, focussing on the conditions that are the most likely causes of this problem. This review is intended to briefly summarise the epidemiology, clinical features, pathophysiology and treatment of a number of conditions which are often associated with chronic productive cough to aid decision making when encountering a patient with this often distressing symptom. The conditions discussed include bronchiectasis, chronic bronchitis, asthma, eosinophilic bronchitis and immunodeficiency. We also propose an adult version of the paediatric diagnosis of protracted bacterial bronchitis (PBB) in patients with idiopathic chronic productive cough who appear to respond well to low dose macrolide therapy.
 

Respir Med. 2015 Jul 6. pii:S0954-6111(15)30001-9.doi:10.1016/j.rmed.2015.05.020. [Epub ahead of print]