Objective To explore the association between cough patterns and cerebrovascular disease risk, and to provide epidemiological evidence for the early diagnosis and prevention of cerebrovascular disease. Methods During the period from 2010 to 2012 in Guizhou Province, a multi-stage proportional stratified cluster sampling method was used to recruit people with the inclusion criteria of the study into a cohort and a baseline questionnaire for demographic information, lifestyle, and disease history was administered. The incidence of cerebrovascular disease was followed up from 2016 to 2020. Results A total of 4804 subjects were followed up, and 4589 (53.5% were female) subjects were enrolled in final investigation. Compared with non-chronic cough group, there was no statistical significance in the risk of cerebrovascular diseases (P>0.05), however, chronic cough (the risk ratio was 2.00 and the 95% confidence interval ranged from 1.08 to 3.69) was twice as likely to develop cerebrovascular disease as non-cough. Conclusions People with chronic cough are more likely to develop cerebrovascular disease than people without cough. More attention to the management and control of cough should be paid to avoid chronic cough, so as to reduce the risk of cerebrovascular diseases.
Objective Using a simple management strategy to investigate the etiologic spectrum of chronic cough in Chengdu city and its suburbs. Methods Chronic cough patients were randomly recruited fromthe outpatient clinic of Sichuan Provincial People ’s Hospital between July 2011 to May 2012. A conception of “Chronic Airway Inflammatory Cough Syndrome, CAICS”was established including several common causes of cough such as cough variant asthma ( CVA) , eosinophilic bronchitis ( EB) , atopic cough ( AC) , and atypical chronic bronchitis. Based on CAICS, a simplified suspected diagnosis procedure of chronic cough was conducted. Patients were empirically treated. Etiology and efficiency of chronic cough was analyzed. Results A total of 148 patients of chronic cough were recruited. The mean age was ( 43. 0 ±13. 0) years old. There were 72 male and 76 female patients with mean ages of ( 39. 7 ±10. 7) and ( 45. 0 ± 14. 2) years old respectively. The males were younger than the females ( P lt; 0. 05) . There was 96. 6% ( 143/148) of patients suspectedly diagnosed and 3.4% ( 5/148) patients were undiagnosed. The suspected causes of these chronic cough patients were as follows, ie. CAICS ( 57. 5% ) , upper airway cough syndrome ( UACS, 21. 5%) , gastroesophageal reflux cough ( GERC, 9. 1% ) , and others ( 8. 4% ) . A single possible cause was found in 95 patients ( 64.1% ) , two possible causes in 41 patients ( 27. 7% ) , and three possible causes in 3 patients( 2. 0% ) . 12.2% of chronic cough patients were combined with allergic rhinitis ( AR) . Among the diseases, CVA, CAICS and UACS were disposed to coexist with AR. The overall efficiency of empiric management strategy of chronic cough was 83. 7% .Conclusions The etiological spectrum of chronic cough in Chengdu acquired by this strategy was generally consistent with previous findings in China.The three most important causes of chronic cough in Chengdu were CAICS, UACS and GERC. This strategy was simple, effective, economic and feasible. It could be a primary management for chronic cough in some hospital.
胃食管反流(GER)是指胃酸和其他胃内容物反流进入食管，正常人存在一定程度的反流，称为生理性反流。GER 可以引起临床症状，甚至组织病理学的改变。当出现胃烧灼、反酸、胸骨后疼痛等临床症状和(或)组织病理学的改变时，也被称为胃食管反流病(GERD)。以慢性咳嗽为主要临床表现的GERD称为胃食管反流性咳嗽(GERC)。2006年蒙特利尔会议提出了反流性咳嗽综合征的定义 。GERC 是慢性咳嗽的常见原因，发生率为5％~41％ ，存在一定的地区差异。欧美报道极为常见，而日本极为少见，国内 GERC占慢性咳嗽病因的12％。
Objective To investigate the clinical characteristics of upper airway cough syndrome ( UACS) and the relationship of UACS with upper airway diseases, cough variant asthma ( CVA) , and gastroesophageal reflux disease ( GERD) . Methods 92 subjects with chronic cough and throat symptoms and signs were included in the study. The medical records were collected fromall subjects, and 49 subjects suspected for CVA undertook bronchial provocation test. Then the efficacy was evaluated and etiology were analyzed based on the efficacy of targeted treatment. Results Bronchial provocation test yielded positive results in 14 subjects suspected of CVA, accounting for 15. 2% of all cases ( 14/92) . 18. 5% ( 17 /92) of patients had a history of chronic gastritis or combined symptoms of GERD, of whom anti-gastroesophagealreflux treatment was effective. The patients with rhinitis, sinusitis history and/ or symptoms accounted for 33. 7% of cases ( 31 cases) . 51. 1% ( 47/92) of patients had only signs and symptoms of chronic pharyngitis. Conclusions UACS is not only due to the rhinitis and/ or sinusitis but also chronic pharyngitis. Chronic pharyngitis may be secondary to chronic rhinitis/ sinusitis with post nasal drip and gastroesophageal reflux, also may be an independent cause of chronic cough.
目的：观察古方止嗽散加味治疗喉源性咳嗽的疗效。方法：采用加味止嗽散治疗喉源性咳嗽116例，并设西药对照组113例。结果：治疗组有效率87.3%，对照组有效率68.2%，两组比较有显著差异(Plt;0.01)。治疗组不良反应例数为零；对照组不良反应例数约占10.2%。结论：加味止嗽散具有疏风宣肺、清热解毒、利咽祛痰、益气养阴、扶正祛邪、抗病毒、抗菌、抗炎和增强免疫功能等功效，为治疗喉源性咳嗽的有效方药。
ObjectiveTo study the correlation between Periostin, interleukin-33 (IL-33), and chronic cough after thoracoscopic lobectomy in patients with coronary artery bypass grafting (CABG) combined with lung cancer. Methods A total of 102 lung cancer patients at Tianjin Chest Hospital from January 2022 to January 2024 were prospectively enrolled, and they were divided into a chronic cough group and a non chronic cough group based on whether chronic cough occurred after surgery. Serum levels of Periostin and IL-33 were measured on the 1st, 7th, and 14th days post-lobectomy. The Pearson method was employed to analyze the correlation between Periostin and IL-33 levels and the severity of cough. Univariate and multivariate logistic regression analyses were conducted to identify factors influencing the occurrence of chronic cough. Additionally, ROC curve analysis was utilized to assess the potential value of serum Periostin and IL-33 levels in predicting postoperative chronic cough. Results In patients with chronic cough, the peripheral blood Periostin and IL-33 levels measured on days 7 and 14 were significantly higher than those in patients with non-chronic cough, and the interactions between the two groups and at different time points were significant (P<0.001). The degree of cough was positively correlated with the levels of Periostin and IL-33 on days 7 and 14 (P<0.05), but had no significant correlation with the levels on day 1 (P>0.05). In patients with lung cancer, after thoracoscopic lobectomy, Periostin [OR=1.619, 95%CI (1.295, 2.025)] and IL-33 [OR=1.831, 95%CI (1.216, 2.758)] on day 7 and Periostin on day 14 [OR=1.952, 95%CI (1.306, 2.918)] and IL-33 [OR=1.742, 95%CI (1.166, 2.603)] were identified as risk factors for chronic cough. ROC curve analysis showed that the sensitivity of Periostin on day 7 was 69.05%, the specificity was 71.67%, and the AUC was 0.756 [95%CI (0.616, 0.893)]. The sensitivity of Periostin on day 14 increased to 71.43% and the specificity was 76.67%, AUC was 0.762 [95%CI (0.633, 0.898)]. At the same time, the critical value of IL-33 on day 7 was 45.03 pg/mL, the sensitivity and specificity were both 83.33%, the AUC was 0.884 [95%CI (0.789, 0.980)], and the critical value of IL-33 on day 14 was 56.01 pg/mL, the sensitivity was 85.71%, the specificity was 80.00%, and the AUC was 0.899 [95%CI (0.799, 0.999)]. Further regression analysis showed that the sensitivity was 95.24%, the specificity was 95.00%, and the AUC reached 0.993 [95%CI (0.979, 1.000)]. Conclusion Periostin and IL-33 levels, measured at various time points, are abnormally elevated following thoracoscopic lobectomy in patients with combined CABG and lung cancer. These levels significantly correlate with cough severity. Given their predictive potential for chronic cough, these markers are deemed valuable biomarkers.
慢性咳嗽在人群的发生率为3％~40％。导致慢性咳嗽的主要原因是上气道咳嗽综合征(UACS)、哮喘和胃食管反流病(GERD) 。也有学者将UACS简化为鼻炎，体现了以鼻腔和鼻窦炎性疾病为代表的上气道疾病对慢性咳嗽的病因学意义。诊疗非吸烟、未服用血管紧张素转化酶(ACE)抑制剂的慢性咳嗽患者，应首先考虑上述三大类疾病，可以单独或联合存在。由于临床症状可能仅表现为咳嗽，同时，病史中提示性的线索通常有限，都可能增加诊断的难度。