咳嗽变异性哮喘误诊原因及鉴别要点分析OA

Objective To investigate the clinical characteristics,causes of misdiagnosis and preventive measures of cough variant asthma(CVA).Methods A retrospective analysis was conducted on the data of 10 patients with misdiagnosed CVA that were admitted from June 2022 to June 2024.Results Among the 10 patients,there were 6 males and 4 females,aged from 18 to 45 years.Three patients presented with persistent cough with scant white sticky sputum.Physical examination revealed no obvious rales in both lungs,and chest X-ray examination showed thickened lung markings.The initial diagnosis was chronic bronchitis,but anti-infection and cough relief treatments were ineffective.Afterwards,the diagnosis of CVA was confirmed by bronchial provocation test.Three patients presented with recurrent cough,runny nose and nasal congestion as the main symptoms.The initial diagnosis was upper respiratory tract infection,but antiviral and symptomatic treatments did not relieve the symptoms.They were diagnosed with CVA through pulmonary function tests and allergen tests.Four patients presented mainly with irritating dry cough accompanied by throat itching.Laryngoscopy showed congestion of the pharyngeal mucosa,and the initial diagnosis was chronic pharyngitis.After treatment,the symptoms recurred.Eventually,they were diagnosed with CVA through bronchial provocation tests and other examinations.The misdiagnosis of the 10 patients in this group lasted 1 to 3 months.After diagnosis,the patient was treated with inhaled glucocorticoids combined with Bronchodilators,and all symptoms improved significantly.Conclusion The clinical manifestations of CVA lack specificity and are easily confused with chronic bronchitis,upper respiratory tract infections and chronic pharyngitis.Clinicians should enhance their understanding of CVA,attach importance to the differential diagnosis of chronic cough,and conduct timely tests such as pulmonary function and bronchial provocation tests to reduce misdiagnosis and mistreatment.