Unexplained Chronic Cough Causes Diagnose And Preliminary Clinical Characteristics Analyze For Elderly

[Objective] In order to provide references for diagnos and treatment of unexplained chronic cough(referred to as chronic cough) elderly patients, the elderly and non-elderly chronic cough patients were enrolled for study, the causes of chronic cough were dignose and the clinical characteristics were preliminary observed for common diseases.[Methods] 65 elderly patients and 72 non-elderly patients, which corresponded to the chronic cough diagnos standards proposed by guidelines of diagnostic and management for cough(referred to as cough guidelines) which promulgated by the Chinese Society of Respiratory Diseases credits will Asthma Study Group in 2009, and had seek medical help for chronic cough treatment from the respiratory medicine of Hunan Province Mawangdui hospital from August 2012 to May 2014, were enrolled as objects for research. The etiological diagnosis was carried out in accorde with procedures recommended by cough guidelines. The causes of chronic cough were analyzed and compared between elderly and non-elderly patients, furthermore, the clinical characreristic of elderly and non-elderly patients were compared in accordance with the commen causes of the chronic cough.[Results] All of the 65 cases of elderly patients with chronic cough were defined as single cause cough, including 15 cases of ACEI-related cough, 14 cases of gastroesophageal reflux cough, 9 cases of chronic bronchitis, 10 cases upper airway cough syndrome, 4 cases of chronic cardiac insufficiency, 4 cases of cough variant asthma, 4 cases of eosinophilbronchitis, three cases of interstitial lung disease, two cases of bronchiectasis. For 72 cases of non-elderly patients with chronic cough, 71 cases were cause defined, including 69 cases of single cause and 2 cases of double causes(CVA merger gastroesophageal reflux disease), the patients with single cause of cough were defined as 18 cases of cough variant asthma, 17 cases of gastroesophageal reflux cough, 16 cases of upper airway cough syndrome, five cases of eosinophilic bronchitis, four cases of chronic bronchitis, three cases of bronchiectasis, three cases of ACEI related cough, two cases of interstitial lung disease, one case of allergic cough. Statistical analysis showed that the ACEI-related cough and chronic heart failure cough is more common in olderly group than in non-elderly group, while cough variant asthma is more common in non-elderly than in elderly.The research results proposed that ACEI related cough cough is one of the most common causes of chronic cough of elderly, moreover, the results prompted that gastroesophageal reflux cough is more common whereas eosinophilic bronchitis is relatively rare in chronic cough patients from Hunan province. Through clinical characteristics analyse, the study discovered that the clinical symptoms of gastroesophageal reflux desease and chronic nasal-sinusitis is relatively not typical in the elderly when compared with non-elderly, and physicians should pay more attention when management elderly chronic cough patients. The study found 25 of the 33 gastroesophageal reflux cough patients complain a time-related aggravating cough from go to bed to sleep, indicating that this clinical feature is important tip significance for diagnosis of gastroesophageal reflux cough.[Conclusions] 1. The causes of chronic cough in elderly patients is different from in non-elderly patients, the most commom causes of chronic cough in elderly are ACEI-related cough, gastroesophageal refluxcough, upper airway cough syndrome, and chronic bronchitis, whereas are cough variant asthma, gastroesophageal reflux cough and upper airway cough syndrome in non-elderly. 2. The clinical symptoms of gastroesophageal reflux desease and chronic nasal-sinusitis are relatively not typical in elderly. 3. A time-related aggravating cough from go to bed to sleep is important tip significance for diagnosis of gastroesophageal reflux cough.