成人上气道咳嗽综合征139例临床特征分析

Clinical features of upper airway cough syndrome in adults: an analysis of 139 cases

摘要:

目的 探讨成人上气道咳嗽综合征（upper airway cough syndrome，UACS）患者的临床特征，分析合并变应性鼻炎（allergic rhinitis，AR）和非变应性鼻炎（non-allergic rhinitis，NAR）患者之间存在的临床特征差异。方法 前瞻性分析2021 年7月至2022年6月在重庆医科大学附属第一医院耳鼻咽喉科治疗的139例UACS患者临床资料，将其分成NAR组和AR组。结果 确诊UACS患者139例，中位年龄39岁，女性占55.4%，其中AR患者49例（35.3%），NAR患者90例（64.7%）。中位咳嗽病程8（4，24）个月，平均莱切斯特咳嗽问卷（Leicester Cough Questionnaire，LCQ）评分（13.39±2.60）分。最常见的症状是流涕（84.2%）和鼻阻（72.7%）。鼻窦计算机断层扫描（computed tomography，CT）最常见的异常是鼻中隔偏曲（55.3%）和鼻甲肥大（52.4%）。以UACS作为慢性咳嗽的唯一原因有93例患者（66.9%）。AR合并哮喘的比例高于NAR（40.8% vs. 3.3%，P<0.001）。AR患者和NAR患者在年龄、性别、病程时间、生活质量评分和白细胞计数方面没有统计学差异。结论 UACS最常见的病因是NAR，除慢性咳嗽合并AR患者易出现鼻痒以外，慢性咳嗽伴AR或NAR的其他临床特征相似。鼻中隔偏曲在NAR患者中更常见，而鼻甲肥大更多见于AR患者。NAR与UACS的关系需进一步研究证明。

Abstract:

Objective To investigate the clinical features of adult patients with upper airway cough syndrome（UACS） and the differences in clinical features between patients with allergic rhinitis（AR） and those with non-allergic rhinitis（NAR）.Methods A prospective analysis was performed for the clinical data of 139 patients with UACS who were treated in the Otolaryngology Department of The First Affiliated Hospital of Chongqing Medical University from July 2021 to June 2022，and they were divided into NAR group and AR group.Results There were 139 patients with a confirmed diagnosis of UACS，with a median age of 39 years，and female patients accounted for 55.4%. Among these 139 patients，there were 49 patients with AR（35.3%） and 90 patients with NAR（64.7%）. The median course of cough was 8（4，24） months，and the mean Leicester Cough Questionnaire（LCQ） score was 13.39±2.60. The most common symptoms were rhinorrhea（84.2%） and nasal congestion（72.7%），and the most common abnormalities on sinus CT were nasal septum deviation（55.3%） and nasal turbinate hypertrophy（52.4%）. UACS was the sole cause of chronic cough in 93 patients （66.9%）. The AR group had a significantly higher proportion of patients with asthma than the NAR group（40.8% vs. 3.3%，P<0.001），and there were no significant differences between the two groups in age，sex，course of the disease，quality of life score，and white blood cell count.Conclusion NAR is the most common cause of UACS. Except that patients with chronic cough and AR tend to have itchy nose，the other clinical features are similar between chronic cough with AR or NAR. Nasal septal deviation is more common in patients with NAR，while turbinate hypertrophy is more common in patients with AR. Further studies are needed to prove the association between NAR and UACS.