咳嗽性晕厥的临床特征：一项系统综述。
完整摘要 · 中文译文
背景：咳嗽性晕厥（CS）是一种罕见的晕厥亚型，在循证医学中仍缺乏充分代表性。我们旨在描述CS的临床特征，以提高对其的认识并优化管理策略。 方法：我们呈现5例CS病例，并基于已发表文献对其临床特征进行系统综述，以提高认识并优化管理。筛选符合条件患者的报告，并分析人口学、临床、诊断、治疗和结局数据。 结果：本研究纳入60例患者，平均年龄为56 ± 15岁，其中91%为男性。最常见的潜在诱因为呼吸系统疾病，包括肺部感染（35%）和支气管炎（22%）。常见合并症包括高血压（26%）、支气管哮喘（18%）和糖尿病（15%）。93%（26/28）的患者CS发作由剧烈咳嗽直接诱发。20%的患者每天至少发作两次，22%的患者晕厥伴有肢体抽搐。98%的病例治疗后症状改善。在中位随访3.75个月（四分位距：2-12个月）后，晕厥复发率为11%。CS主要由剧烈咳嗽诱发，主要影响中老年男性。 结论：CS主要影响中老年男性，且常与肺部感染相关。急性肺部感染是CS常见的潜在诱因，患者存在晕厥复发和跌倒的风险。疾病管理应 重点关注慢性气道疾病的治疗，尤其是慢性阻塞性肺疾病。
完整摘要 · 英文原文
BACKGROUND: Cough syncope (CS) is a rare subtype of syncope that remains underrepresented in evidence-based medicine. We aimed to characterize the clinical features of CS, with the aim of improving recognition and optimizing management strategies. METHODS: We present five cases of CS alongside a systematic review of its clinical characteristics based on published literature to improve recognition and optimize management. Reports of eligible patients were screened, and demographic, clinical, diagnostic, treatment, and outcome data were analyzed. RESULTS: This study included 60 patients with a mean age of 56 ± 15 years, 91% of whom were male. The most common underlying triggers were respiratory diseases, including pulmonary infections (35%) and bronchitis (22%). Common comorbidities included hypertension (26%), bronchial asthma (18%), and diabetes mellitus (15%). CS episodes were directly triggered by severe coughing in 93% (26/28) of patients. Episodes occurred at least twice daily in 20% of patients, and limb convulsions accompanied syncope in 22%. Symptoms improved after treatment in 98% of cases. After a median follow-up of 3.75 months (Interquartile Range: 2-12 months), the recurrence rate of syncope was 11%. CS, predominantly triggered by severe coughing, primarily affected middle-aged and older men. CONCLUSIONS: CS predominantly affects middle-aged and older men and is frequently associated with pulmonary infections. Acute pulmonary infections serve as a common underlying trigger for CS, and patients are at risk of recurrent syncope and falls. Disease management should be focused on treating chronic airway disease, particularly chronic obstructive pulmonary disease.