Research On The Diagnostic Value Of Fungus Related Index Detection To The Chronic Cough Of Unknown Etiology

BackgroundCough is a common respiratory symptom, It is accounted for about40%ofRespiratory Outpatient service.Chronic cough refers to cough as the only or mainsymptoms, sputum or no sputum, denied a history of chronic respiratory disease,recent chest X-ray examination is difficult to diagnose disease, cough lasted morethan eight weeks. Chronic cough occurrence rate in the population is about3%-40%,the cause is complex, and some patients exist a variety of causes, the causes firstcarry out in the1980s, Irwin presented chronic cough anatomic diagnostic procedures,pointed out the most common cause is postnasal drip syndrome (PNDS), coughvariant asthma (CVA) and gastroesophageal reflux disease (GERD) and so on. Butpart of patients have failed to get a clear diagnosis, long-term persistentcough,ineffective conventional treatment, may be caused by the pathogeny ofpreviously did not know or did not pay attention to.With the improvement of industrial technology level, environmental pollution is increasingly serious, the incidence of respiratory is more and more high, chronicfungal infection in respiratory diseases is also more and more high. It often have notypical clinical manifestation in early time, most cases of intractable cough as soleclinical manifestation, and delayed healing of illness, conventional treatment ispoor.with the progress of disease, may cause the decline of lung function, respiratoryfailure and other serious complications, early diagnosis, early treatment has a positivesignificance to improve the prognosis. But fungal infection insidious onset,anddifficult to obtain pathogen. This study is based on this, to detection fungi relatedindicators: the detection rate specific IgE (sIgE), G test, GM test in chronicintractable cough without a clear diagnosis and compare statisticalsignificance,explore its diagnostic value, aimes at finding a quick, convenient andefficient detection of fungal index, Providing reference to diagnosis and treatment forfuture work.Objects.Analysis the cause of chronic cough and category in our hospital.explore fungirelevant indicators: SIgE, G test, GM test in the diagnostic value of unknown etiologyof chronic cough.MethodsChoose186chronic cough patients in the breathe3outpatient of the FirstAffiliated Hospital of Zhengzhou University from September2011to January2014,90cases were males and96cases were females, aged16-78years, the averageage were (39.62±15.23) years old. Cough time2months to240months, the average(18.81±16.57)months.All the cases were diagnosed using chronic cough diagnosticprocedure and combined with the patient’s condition.Then confirm the cause bydiagnostic treatment, eliminate definite diagnosis cases, The rest of the etiological diagnosis is unclear and the poor treatment cases. Further to do specific fungalIgE(sIgE), G test, GM test, and give experimental antifungal therapy, comparingfungal related indicators negative group and positive group have statisticallysignificant treatment effect.and to detect fungal-related indicators in the positive rateof antifungal therapy effective cases, compare statistical difference.ResultsIn this study, our hospital186chronic cough cases,distribution cause: coughvariant asthma:51cases; upper airway cough syndrome:35cases; gastroesophagealreflux disease:26cases; eosinophils bronchitis:11cases; angiotensin convertingenzyme drug-induced three cases; multiple etiologies three cases.unknown etiology57cases.57patients of unknown etiology, check sIgE, G test, GM test,one or moreindicators positive of47cases.Cases of unknown etiology, fungal indicators positive group of47cases,10casesof fungal negative indicators, the two groups showed no significant difference, P>0.05in gender, age, duration of cough.Treated with antifungal therapy, the rate of positive effective was80%in fungalindicators positive group, in negative group was20%, compared toχ2test, P <0.05.Cases of unknown etiology,47cases of fungal indicators positive,anti-fungaltreatment was effective in40cases, sIgE, GM test, G test cases in an effectiveantifungal therapy accounted for the positive rates were:77.5%,35%,17.5%. sIgEand G test, GM tests were used to compareχ2test, P <0.05. G test, GM test χ2test,P<0.05. ConclusionCause of chronic cough complex, our hospital is mainly with cough variantasthma, upper airway cough syndrome, gastroesophageal reflux disease，eosinophilic bronchitis, etc.For conventional treatment of chronic intractable cough in poor efficiency, checkone or more fungi related indicators accounted was higher, suggesting that these casesmay have potentially fungal infection.Positive group of fungi related indicators antifungal treatment was significantlyhigher than the negative group of fungi related indicators.SIgE has the highest value in etiology diagnosis of unknown etiology chroniccough, GM trials followed, G test worst.