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:510120():,Email:klai@163.com席寅赖克方陈如冲罗炜陈桥丽王法霞林玲许丹媛杨业(CVA),CVA2002120101CVA,,/PEF18CVA,8,,CVA();91CVA74.7%,46.2%;:63.5%51.4%47.3%37.8%36.5%;CVA74.7%(EOS)2.5%584.2(1~8.5),8(8/58,13.8%),CVA[12(20)vs6(4),P0.05],8112,50CVA3312,(P0.05)CVAEOS%EOS%(P0.05)CVA,,CVA;;;ClinicalcharacteristicsofcoughvariantasthmaanditsrelasionshipwiththeclassicasthmaXIYin,LAIKefang,CHENRuchong,LUOWei,CHENQiaoli,WANGFaxia,LINLing,XUDanyuan,YANGYe.StateKeyLaboratoryofRespiratroyDisease(GuangzhouMedicalCollege),GuangzhouInstituteofRespiratoryDisease,theFirstAffiliatedHospitalofGuangzhouMedicalCollege,Guangzhou510120,ChinaCorrespondingauthor:LAIKefang,Email:klai@163.comAbstractObjectiveTostudytheclinicalcharacteristicsofadultcoughvariantasthma(CVA)andinvestigatetheproportionofCVAdevelopedclassicasthma,exploretheriskfactorsforthedevelopmentofasthmainpatientswithCVA.MethodsTheclinicalcharacteristicsandbasicexaminationsof91CVApatientswereretrospectivelyassessed.Moderatedosebudesonideorcompoundsofbronchodilatorandcorticosteroidwereinhaledinallpatientsatleast8weeks.Accordingtowhetherthepatientsdevelopedasthmaticsymptomsofwheezinganddyspneathroughtheclinicortelephonefollowup,theyweredividedintotwogroupsthepureCVAgroupandtheasthmagroup.Thepulmonaryfunctionparameters,eosinophilproportionofinducedsputumandperipheralblood,skinpricktestpositiverateandICSusageofthesetwogroupswerecompared.ResultsTheincidenceofnocturnalormorningcoughin91CVApatientswas74.7%,theproportionoftheseCVApatientswithallergicrhinitishistorywas46.2%,themajorinducingfactorsofcoughinclude:vaporandsmoke63.5%,coldair51.4%,upper150()2011653ChinJAsthma(ElectronicEdition),June2011,Vol.5,No.3airwayinfection47.3%,dust37.8%,pharynxandlarynxitch36.5%.Theproportionwhoseeosinophilicpercentageinsputumismorethan2.5percentinCVAis74.7%.Duringa4.2(18.5)yearfollowup,8(13.8%)ofthe58patientswereconsideredtohavedevelopedclassicasthmawithwheezing,comparedwihttheasthmagroup,inhaledcorticosteroidstimeinpureCVAgroupissignificantlonger.Only1intheasthmagroupreceivedregularlyICStherapymorethan12weeks,but33inthepureCVAgroup,respectively,thedifferenceinthetwogroupsissignificant(P0.05).Therewasnosignificantdifferencebetweenthetwogroupsaboutthepulmonaryfunctionparameters,eosinophilproportionofinducedsputumandperipheralblood,positiverateofskinpricktest.ConclusionsCVAischaracterizedwithnocturnalormorningcough,andalmosthalfofCVApatientsarewithallergicrhinitishistory,longtermtreatmentwithinhaledcorticosteroidsregularlycanpreventtheprogressionofCVAtoclassicasthma.KeywordsCoughvariantasthma;Asthma;Allergy;Sputum(coughvariantasthma,CVA),,,[13],30%CVA[46],CVA,CVA[45]CVA,CVA,CVA,,2002120101,:18,8,X,CVA[7]:,;8;,;;,1.:,;,(SPT)(EOS)2.:Autobox6200(Sensormedics)FEV120%(PD20FEV1),PD20FEV17.8mol,3.:[8]:3%15~20min,,40.1%,10min,5min,2000r/min10min,HE4.:200g,2/d,4.5~9g,2/d;160/4.5g,2/d;10~15mg,18,:()(CVA),CVA:[7],3d,:;151()2011653ChinJAsthma(ElectronicEdition),June2011,Vol.5,No.3,xs,();SPSS13.0,t,MannWhitneyU,2CVA91,28,63,(43.113.6),24(67)9174.7%(68/91),46.2%(42/91),65.9%(60/91);:63.7%(58/91)50.5%(46/91)48.4%(44/91)37.4%(34/91)36.3%(33/91)51SPT,14SPT(27.5%),SPT31.8%(7/22)24.1%(7/29);50,13EOS%6%;CVA74.7%(65/87)(4EOS)EOS2.5%(1)58,4.2(1~8.5),8(13.8%),4121123432.8%(19/58)8,CVA[12(20)vs6(4)],P0.05(1)50CVA836,1233;83,12112CVA(2.9%)12(29.2%),P0.05(1)CVAEOS%:8.5(29)%PD20:3.9(3.9)molEOS%:15(23.5)%PD20:3.9(4.6)mol(2,3),SPT(1)1CVA,CVACVACVACVA91508(/)28/6318/324/4()43.113.642.014.041.412.7()24(67)24(70.3%)18(68)[(%)]68(74.7)37(74)7(87.5)[(%)]42(46.2)27(54)3(37.5)()a4.1(4.5)5.2(4.9)FEV1%pred(%)95.714.097.314.191.012.7FVC%pred(%)101.414.3101.212.0102.616.7FEV1/FVC(%)81.19.182.810.177.56.2MMEF%pred(%)a66.3(26.1)67.6(29.5)57.5(34.8)PD20FEV1(mol)a3.9(3.9)3.9(3.9)3.9(4.6)EOS%a3.6(4.8)3.7(7.8)3.3(5.9)EOS%6%[/(%)]13/37(26)10/21(32.3)1/4(20)EOS%a7.5(19.5)8.5(29)15(23.5)EOS2.5%[/(%)]65/22(74.7)35/12(74.5)7/1(87.5)SPT(%)[/(%)]14/37(27.5)8/20(28.6)1/2(33.3),a12(20)b6(4):CVA:;FEV1%pred:1;FVC%pred:;FEV1/FVC:1;MMEF%pred:;PD20FEV1:FEV120%;a();xs;CVA,bP0.05152()2011653ChinJAsthma(ElectronicEdition),June2011,Vol.5,No.3:12,aP0.051/12CVA:58CVA,32EOS:PD20FEV1,FEV120%46,12PEF20%3CVA,CVA,91CVA74.7%,Shirahata[9]23CVA91.3%,CVAPEF10%,,,ARIA()80%,10%~40%[10]83.6%[11],3[12]CVA,CVA46.2%,[1011]CVA,,,,CVA[13]CVA,,CVAEOS,CVAEOSEOS[1]Carney[14]63(50%)EOS3%;Fujimura[4]34CVA,15(46.9%)EOS%2.5%CVA74.7%EOS(2.5%),;ACCP,CVA,EOS,EOSCVA(B)[15],CVA153()2011653ChinJAsthma(ElectronicEdition),June2011,Vol.5,No.3,EOS,CVA30%[46],Corrao[6]6CVA182Fujimura[4]55CVA,35,20,3.7,5.7%(2/35),30%(6/20)Matsumoto[5]4413(31%)4,223(13.6%),2010(50%),Koh29CVA16(55.2%)4[16]58CVA4.7,8(13.8%),839CVA7.7%(3/39),819CVA5(26.3%)CVA,CVA[45,17]CVA,,CVA,,CVA?CVA8[7],CVA8,EOS1/38,CVA8,,CVA,12CVACVA,CVA,,CVAFEV1[18],CVACVA[45]CVA,Fujimura[4]PC20CVACVA,PC20CVA[19]Matsumoto[5]42CVA4,CVAKoh(FEV1)PC20CVA[20],Koh4CVA[16]CVA[2122]PC20CVA(/)/CVAEOS[1,23],Kim[24]EOSCVA,CVA:15%,,CVA,;CVACVAEOS,Fujimura[19],,(CVA,KimCVA)Nakajima[21]28CVA5,CVA,CVACVA[22][17]CVACVAEOS,CVA58,4.2(1~8.5),,[45,17,20,22,24],,,CVA,154()2011653