咳嗽变异性哮喘(CVA)是一种特殊类型的哮喘,儿童尤为多见。临床上以慢性持续性干咳为唯一或主要临床症状,夜间症状更显著,临床无感染征象,抗生素治疗无效,但多有较明确的家族过敏史或个人过敏史,过敏指标或炎性指标可升高。肺功能大多正常或仅轻度减退,支气管激发试验提示支气管高反应性的存在是CVA的特征性表现,但并非确诊的依据。支气管扩张剂的良好治疗反应是诊断最可靠的依据。本病需与慢性咳嗽的其他原因尤其是嗜酸性粒细胞相关性疾病相鉴别,如上呼吸道咳嗽综合征、变应性咳嗽、嗜酸性粒细胞性支气管炎、胃食管反流病及反复呼吸道感染、感染后咳嗽、异物吸入等,详细的病史、相关实验室检查及辅助检查尤其是特异性治疗的有效性是鉴别诊断的重要依据。 Cough Variant asthma (CVA) is a special type of asthma that is especially common in children. Clinically, chronic persistent dry couch is the only or major clinical symptom, with more obvious symptoms at night, no signs of clinical infection and no antibiotic treatment. However, there are more definite family history of allergy or personal allergy, and allergy or inflammatory index may rise high. Pulmonary function mostly normal or only mild decline, bronchial provocation test suggests that the existence of bronchial hyperresponsiveness is the characteristic manifestation of CVA, but not based on the diagnosis. Good therapeutic response to bronchodilators is the most reliable basis for diagnosis. The disease and other causes of chronic cough, especially eosinophil-related diseases, such as upper respiratory tract cough syndrome, allergic cough, eosinophilic bronchitis, gastroesophageal reflux disease and recurrent respiratory tract infections, Cough infection, foreign body inhalation, etc., a detailed history, laboratory tests and laboratory tests, especially the effectiveness of specific treatment is an important basis for differential diagnosis.