小儿咳嗽变异性哮喘57例临床分析

目的探讨儿童咳嗽变异性哮喘（cough variant asthma，CVA）的临床特点，提高诊断意识。了解目前常用治疗方法的有效性。方法回顾性分析本院57例CVA患儿临床表现和误诊原因，应用博利康尼和息斯敏进行治疗，观察其疗效。结果CVA以慢性咳嗽为主要表现，缺少肺部体征，本组患者在本院确诊前有39例被误诊，其中误诊为反复上呼吸道感染19例。有个人过敏史37例。皮肤变应原试验、支气管扩张试验和IgE检查有助于临床诊断。博利康尼和息斯敏治疗CVA效果显著。结论CVA患儿的临床表现不典型，提高对该病的认识、熟练掌握诊断标准是防止误诊和误治的关键，确诊后通过支气管扩张剂（β2受体激动剂）博利康尼和组胺H1受体拮抗剂息斯敏治疗效果良好。

Clinical analysis of 57 children cases with CVA

Objective To study the clinical characteristic of children with cough variant asthma(CVA)and outcome of nowadays therapy.Methods Clinical characteristics of 57 children patients with CVA and the possible reasons for being misdiagnosed were analyzed retrospectively.Terbutaline sulfate and Astemizole were used for treatment and the curative effects were observed.Results The main characteristic of CVA was chronic cough,without pulmonary sign.Before final diagnosis,39 cases were misdiagnosed,among which 19 cases were treated as recurrent infection in up respiratory tract,37 cases had allergic history.Skin allergen test,bronchi dilation test and Ig E examination could help differential diagnosis.Terbutaline sulfate and astemizole had profound effects in treatment of CVA in children.Conclusion Clinical symptom of CVA in children is not specific.Improving recognition of this disease and well use of diagnosis criteria are the key to avoid wrong diagnosis and treatment.Applications of Terbutaline sulfate and Astemizole have good curative effects.