儿童咳嗽变异型哮喘40例的临床特点

目的 探讨儿童咳嗽变异型哮喘的临床特点.方法 回顾性分析笔者所在医院2005年1月～2010年1月诊治的40例咳嗽变异型哮喘患儿的临床资料.结果 临床表现以发作性干咳为主,多夜间早晨出现发作性;80.0%春秋季发病,多有家族过敏史及个人过敏史;咽部充血4例,扁桃体Ⅰ～Ⅱ度肿大2例,双肺呼吸音增粗6例;辅助检查白细胞计数多正常,可伴嗜酸细胞计数增高,胸部X线检查示肺纹理粗乱4例;血沉检查正常.平均误诊时间为（4.32±1.26）个月.采用舒喘灵加酮替芬治疗,咳嗽在2～5 d消失14例,7 d左右消失8例,其余15～45 d消失.结论 儿童咳嗽变异型哮喘并不少见,应提高对其认识,一旦临床确诊,给予支气管扩张剂、β2受体激动剂,单一或联合用药,必要时应用肾上腺糖皮质激素.

Clinical characteristics of cough variant asthma in 40 children

Objective To investigate the clinical features of children with cough variant asthma （CVA）. Methods To retrospectively analyze clinical data of 40 cases of CVA in children in our hospital from January 2005 to January 2010. Results The main clinical manifestation of cough variant asthma was paroxysmal dry cough at night or in the morning ; 80. 0% of the patients attacked in spring or autumn, with a family history of allergy and personal history of allergies, pharyngeal congestion in 4 cases, tonsil Ⅰ-Ⅱ degree of swelling in 2 cases, thickening lung breath sounds in 6 cases; white blood cell count increased in most patients; chest X - ray examination showed crude disorder lung markings in 4 cases ; ESR were norreal. The average misdiagnosed time was （4.32 ± 1.26） months. By using salbutamol plus ketotifen, cough disappeared in 2 -5 days in 14 eases, 7 days in 8 cases, and 15 -45 days in the others. Conclusion We should raise awareness of the CVA, once confirmed, the patients should be given bronchodilators and β2 agonists, if necessary, corticosteroids should be given.