慢性咳嗽评价和治疗的争论
2011/03/24
摘要
基础评价不能解释的慢性咳嗽是患者至呼吸科门诊就诊的常见原因。哮喘、胃-食道反流（GER）和上呼吸道疾病常常与慢性咳嗽并存。而这些疾病是否是导致咳嗽或咳嗽加重的原因，目前尚存在争论。咳嗽反射敏感性增加是慢性咳嗽患者的一个主要特征。有证据显示，如果慢性咳嗽与上呼吸道感染、血管紧张素转换酶抑制剂及嗜酸性粒细胞性气道炎症相关，则慢性咳嗽是可逆性的。在许多患者中，咳嗽反射敏感性增加持续存在，而且咳嗽病因不明。对于不明原因的慢性咳嗽，有关治疗选择也较少。有必要了解不明原因咳嗽的遗传学、分子学和生理学基础，以开发出能下调咳嗽反射敏感性的止咳药物。
（林江涛 审校）
Am J Respir Crit Care Med. 2010 Dec 10. [Epub ahead of print]
Controversies in the Evaluation and Management of Chronic Cough.
Birring SS.
King’s College London, Division of Asthma, Allergy and Lung Biology, London, United Kingdom.
Abstract
Chronic cough that cannot be explained after basic evaluation is a common reason for patients to be referred to respiratory out-patient clinics. Asthma, gastro-esophageal reflux (GER) and upper airway disorders frequently co-exist with chronic cough. There is some controversy as to whether these conditions are causes or aggravants of cough. Heightened cough reflex sensitivity is an important feature in most patients. There is good evidence that it is reversible when associated with upper respiratory tract infection, angiotensin converting enzyme inhibitor medications and chronic cough associated with eosinophilic airway inflammation. In many patients, heightened cough reflex sensitivity is persistent and cough unexplained. There are few therapeutic options for patients with unexplained chronic cough. There is a pressing need to understand the genetic, molecular and physiological basis of unexplained chronic cough and develop novel antitussive drugs that down-regulate cough reflex sensitivity.
Am J Respir Crit Care Med. 2010 Dec 10. [Epub ahead of print]
基础评价不能解释的慢性咳嗽是患者至呼吸科门诊就诊的常见原因。哮喘、胃-食道反流（GER）和上呼吸道疾病常常与慢性咳嗽并存。而这些疾病是否是导致咳嗽或咳嗽加重的原因，目前尚存在争论。咳嗽反射敏感性增加是慢性咳嗽患者的一个主要特征。有证据显示，如果慢性咳嗽与上呼吸道感染、血管紧张素转换酶抑制剂及嗜酸性粒细胞性气道炎症相关，则慢性咳嗽是可逆性的。在许多患者中，咳嗽反射敏感性增加持续存在，而且咳嗽病因不明。对于不明原因的慢性咳嗽，有关治疗选择也较少。有必要了解不明原因咳嗽的遗传学、分子学和生理学基础，以开发出能下调咳嗽反射敏感性的止咳药物。
（林江涛 审校）
Am J Respir Crit Care Med. 2010 Dec 10. [Epub ahead of print]
Controversies in the Evaluation and Management of Chronic Cough.
Birring SS.
King’s College London, Division of Asthma, Allergy and Lung Biology, London, United Kingdom.
Abstract
Chronic cough that cannot be explained after basic evaluation is a common reason for patients to be referred to respiratory out-patient clinics. Asthma, gastro-esophageal reflux (GER) and upper airway disorders frequently co-exist with chronic cough. There is some controversy as to whether these conditions are causes or aggravants of cough. Heightened cough reflex sensitivity is an important feature in most patients. There is good evidence that it is reversible when associated with upper respiratory tract infection, angiotensin converting enzyme inhibitor medications and chronic cough associated with eosinophilic airway inflammation. In many patients, heightened cough reflex sensitivity is persistent and cough unexplained. There are few therapeutic options for patients with unexplained chronic cough. There is a pressing need to understand the genetic, molecular and physiological basis of unexplained chronic cough and develop novel antitussive drugs that down-regulate cough reflex sensitivity.
Am J Respir Crit Care Med. 2010 Dec 10. [Epub ahead of print]
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慢性咳嗽治疗的新概念
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病毒性上呼吸道感染对咳嗽急迫感的影响
