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.
Objective To investigate the different clinical features of chronic cough induced by rhinitis /sinusitis or gastro-esophageal reflux, and its significance for etiological diagnosis of chronic cough.Methods Chronic cough patients were recruited from respiratory medicine clinic in Chongqing Xinqiao Hospital from December 2009 to December 2010. Medical history, symptoms and signs were recorded from all selected patients. The patients with chronic rhinitis / sinusitis, but without gastro-esophageal reflux symptoms were suspected upper airway cough syndrome ( UACS) , and given chlorpheniramine, nasal decongestant, and corticosteroid treatment for 1 week. The patients with clinical symptoms associated with gastroesophageal reflux or with history of gastric diseases were suspected gastroesophaged reflux-related cough ( GERC) , were given esomeprazole ( 40 mg, bid) , combined prokinetic agent for 2 weeks. The patients were confirmed the diagnosis of UACS or GERC when their cough was relieved after the above targeted treatment.Results 114 patients were enrolled in this study. 47 patients were suspected GERC, of which 32 were confirmed, and 67 patients were suspected UACS, of which 43 were confirmed. There was no significant difference in age, duration of disease, severity of cough, proportion of night cough, proportion of clear throat symptom, or proportion of cobblestone sign between the UACS patients and the GERC patients ( P gt;0. 05) .There were more females in the GERC patients and more males in the UACS patients ( P lt; 0. 05) . Cough with sputum, throat symptoms and signs were more common in the UACS patients ( P lt;0. 05) . The hoarseness and sore throat symptoms were found only in the GERC patients, but postnasal drip symptoms were found only in the UACS patients. Conclusions Throat signs and symptoms are not completely similiar in the GERC and the UACS patients. Comprehensive judgments combining with patient history,characteristics of concurrent cough, throat symptoms, and signs can provide important references for the clinical diagnosis of chronic cough caused by rhinitis/ sinusitis or gastro-esophageal reflux.
Objective To investigate the clinical characteristics of neutrophilic asthma ( NA) .Methods NA patients were collected from the out-patient and in-patient departments of Respiratory Diseases of Xinqiao Hospital between January 2010 and December 2010. The results of the medical records,pulmonary function tests, and induced sputum cytology were analyzed retrospectively. Results The NA patients with neutrophil percent ≥ 61% accounted for 33. 1% ( 51 /154 ) of all the asthmatics patients detected by induced sputumin the same period, and 45 cases with complete records were included. Of the 45 cases recruited, 20 cases ( 44. 4% ) were in-patients,2 cases ( 4. 4% ) were with controlled asthma, 3 cases ( 6. 7% ) were with cough variant asthma, 30 cases ( 66. 7% ) were female, 12 cases ( 26. 7% ) were atopic patients, and 27 cases ( 60% ) had acute exacerbation. The age of onset of 35 patients ( 77. 8% ) were after 12 years. FEV1% pred lt; 60% and gt; 80% was obtained in 55. 9% ( 19/34) and 14. 7% ( 5 /34) of patients respectively. The result of bronchodilator test was positive in 64% ( 16/25) of patients, and mean increase in FEV1 was 11. 7% . The percentage of neutrophil and eosinophil was ( 74. 5 ±9. 1) % and ( 2. 4 ±2. 5) % respectively in induced sputum, and 35. 6% ( 16/45) of the patients had increased eosinophil percentage ( gt;3% ) . Conclusions In our study, most of NA is severe and acute exacerbation asthma, and its clinical features are various. The mechanismand clinical significance of increased neutrophils in asthmatic patients are unclear and more studies are needed.