Eosinophilic bronchitis
Eosinophilic bronchitis
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嗜酸粒细胞性支气管炎
DOI：
10.1016/s0140-6736(01)06224-9
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发表时间：
2001
期刊：
影响因子：
--
通讯作者：
F. Hargreave
中科院分区：
文献类型：
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作者：
R. Hancox;R. Leigh;M. Kelly;F. Hargreave
Sir-Gibson及其同事1于1989年首次描述了7名表现为慢性咳嗽的嗜酸性粒细胞性支气管炎患者。不久之后又发现了另外5名患者，并将其纳入另一份报告，其中该疾病通过吸入性皮质类固醇治疗得到改善。[2]不伴哮喘的嗜酸性支气管炎已被认为是慢性咳嗽的一个原因，在10-15%的转诊接受专家调查的患者中，它似乎是根本原因。3然而，其自然史和长期预后尚不清楚。因此，我们对原始报告中的患者进行了随访。1，2三名患者失访，一名患者死于肺栓塞（尸检时证实）。她死的时候有轻微的哮喘。她的主要症状是咳嗽，这是治疗间歇性疗程吸入皮质类固醇。她死前2个月的临床检查显示肺功能和气道反应性正常。我们联系了其余8例患者，其中6例能够参加临床审查、乙酰甲胆碱激发和诱导痰。没有人因嗜酸性支气管炎、哮喘或其他气道疾病接受治疗。1例患者在过去6个月内接受了吸入性皮质类固醇，但在2个月前因不再有症状而停用。在4例患者中，咳嗽完全消退，而在4例持续咳嗽患者中，2例有胃食管反流和鼻后滴涕症状，1例仅有鼻后滴涕症状，1例随后在高分辨率计算机断层扫描上被确认为轻度局部支气管扩张。他也有轻微的气流限制。1例患者出现中度气流受限，但有60包年吸烟史。无患者发生气道过度-
Sir—Gibson and colleagues1 first described eosinophilic bronchitis without asthma in 1989 in seven patients presenting with chronic cough. A further five patients were identified shortly afterwards and were included in another report in which the disorder improved with inhaled corticosteroid treatment. 2 Eosinophilic bronchitis without asthma has since been recognised as a cause of chronic cough, and it seems to be the underlying cause in 10–15% of patients referred for specialist investigation. 3 However, the natural history and long-term prognosis are unknown. Therefore, we followed up the patients from the original reports. 1, 2Three patients have been lost to follow-up and one has died from a pulmonary embolus (confirmed at necropsy). She had mild asthma at the time of her death. Her main symptom was cough, which was treated with intermittent courses of inhaled corticosteroid. Clinical review 2 months before her death showed normal spirometry and airway responsiveness. We contacted the remaining eight patients, six of whom were able to attend for clinical review, methacholine challenge, and sputum induction. None were being treated for eosinophilic bronchitis, asthma, or other airway disorders. One patient had received inhaled corticosteroids in the past 6 months but had stopped them 2 months earlier because she was no longer symptomatic. In four patients the cough had completely resolved, whereas in the four with persisting cough, two had symptoms of gastro-oesophageal reflux and postnasal drip, one had symptoms of postnasal drip alone, and one was subsequently recognised as having mild localised bronchiectasis on highresolution computed tomography. He also had mild airflow limitation. One patient had developed moderate airflow limitation but had a 60 packyear smoking history. No patient had developed airway hyper-