氨茶碱鉴别咳嗽变异性哮喘的临床意义(1)
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[摘要] 目的：探讨氨茶碱在急诊科鉴别咳嗽变异性哮喘中的临床意义，为临床急诊医生进一步指引患者进行专科治疗提供一定的客观依据。方法：将120例诊断为慢性咳嗽的患者随机分为两组，每组60例，观察组在使用抗生素的基础上配合使用氨茶碱，对照组使用抗生素，两组均进行相应的常规治疗，观察氨茶碱组与其他3种检测方法的阳性率，与抗生素治疗比较疗效判断指标。结果：氨茶碱推测性诊断的阳性率是51.7%。结论：氨茶碱能够缓解咳嗽变异性哮喘症状，为临床医生的诊断思路以及患者早期进行治疗提供帮助。
[关键词] 氨茶碱；咳嗽变异性哮喘；鉴别；临床意义
[中图分类号] R562.2 [文献标识码] A [文章编号] 1674-4721(2011)12(b)-022-02
Clinical significance of aminophylline in identification of cough variant asthma
HUANG Peiquan, WU Shengkai
Department of Emergency of Puning People's Hospital, Guangdong Province, Puning 515300, China
[Abstract] Objective: To provide clinical emergency doctors with some objective basis of guiding patients in receiving specialty treatment by investigating the clinical significance of aminophylline in the identification of cough variant asthma in the emergency department. Methods: One hundred and twenty cases of patients diagnosed as chronic cough were randomly divided into two groups of 60 patients each. The observation group received additional aminophylline on the basis of antibiotics while the control group received antibiotics. Both groups received the conventional treatment. The positive rate of the aminophylline group compared with those of the other three test methods was observed. The curative effects indicators of the aminophylline group were compared with those of the antibiotics group. Results: The positive rate of speculated diagnosis of aminophylline was 51.7%. Conclusion: Aminophylline can relieve the symptoms of cough variant asthma and help clinicians with the diagnosis thinking and early treatment of patients.
[Key words] Aminophylline; Cough variant asthma; Identification; Clinical significance
以长期持续咳嗽咳痰为主诉就诊的门诊患者不占少数，这些患者往往被诊断为慢性咳嗽，慢性咳嗽涵盖了许多基础疾病原因，有一部分初诊时未能得到明确诊断的患者，咳嗽长期持续,常规抗生素治疗无效，尤其是咳嗽变异性哮喘(CVA)近年来占慢性咳嗽病因中25.0%～33.3%[1]，由于其发生变化的隐匿性和无特异性，导致诊断和治疗的困难，笔者发现使用氨茶碱治疗后，与其他实验室诊断相比，具有初步筛查的作用，并且能够迅速缓解症状，现报道如下：
1 资料与方法
1.1 一般资料
120例均为本科2009年3月～2011年3月就诊的患者，其中，男64例，女56例，年龄13～71岁，平均(35.5±7.8)岁，病程(10.2±5.6)年。所有患者均表现为慢性咳嗽，胸闷，痰多或无痰，符合慢性咳嗽的诊断标准：无呼吸道感染病史，以咳嗽持续时间>8周；X线胸片或胸部CT未见明显病变者，所有患者2周内均未使用激素类药物、支气管扩张剂以及抗组胺药，排除支气管哮喘、心源性哮喘、心功能不全者，患者病程、病情程度、性别、年龄均具有可比性 ......
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