重庆地区儿童慢性咳嗽病因构成比及其随访

目的 了解引起重庆地区儿童非特异性慢性咳嗽的病因构成比,分析病因特点.方法 根据中华医学会儿科分会呼吸学组与中华儿科杂志制订的<儿童慢性咳嗽诊断与治疗指南>的标准,对2008年6月至2009年4月重庆医科大学附属儿童医院呼吸中心哮喘专科门诊共266例慢性咳嗽儿童,按照指南的诊断流程询问病史,体格检查,辅助检查,在初步确定病因后,针对病因进行特异性治疗,分别于初诊后半个月,1个月和3个月随访,根据治疗效果确定病因诊断,进而统计病因构成比.结果 随访后266例患儿确诊病因例数及构成比由高到低依次为:咳嗽变异性哮喘(CVA)125例(47.0%),CVA+上气道咳嗽综合征(UACS)58例(21.8%),呼吸道感染和感染后咳嗽44例(16.5%),UACS 35例(13.2%),随访结束时原因仍不明者3例(1.1%),心因性咳嗽1例(0.4%).年龄组病因:≤3岁组CVA 70.0%(35/50),呼吸道感染和感染后咳嗽20.0%(10/50);3～6岁组中CVA占50.7%(71/140);≥6岁组各病因间差异无统计学意义(P>0.05).不同年龄组间病因构成比差异有统计学意义(P<0.05).结论 引起重庆地区儿童非特异性慢性咳嗽前4位病因依次为CVA,CVA+UACS,呼吸道感染和感染后咳嗽,UACS,不同年龄组儿童慢性咳嗽的病因构成比不同.

Proportion of incidence of etiological agents in children with non-specific chronic cough in Chongqing: a follow-up study

Objective To investigate the proportion of incidence of children with non-specific chronic cough in Chongqing and analyze the characteristics of etiology during the follow-up.Method Diagnostic criteria were defined for children with non-specific chronic cough according to the Guidelines of diagnosis and therapy for children with chronic cough that were formulated by the Subspecialty Group,Society of Pediatrics,Chinese Medical Association and Chinese Journal of Pediatrics in 2008.Totally 266 patients in whom cough was the main or the only symptom,lasting>4 weeks,presenting to Asthma Center of Children's Hospital,Chongqing Medical University between June 2008 and April 2009 were recruited into this study.Based on the Guidelines,diagnosis was made after taking history,physical examination and assistant examination.After etiological treatment,the patients were followed up during the second week,the fourth week and the twelfth week.Etiological diagnosis was confirmed if cough was resolved after specific therapy.If cough Was not resolved,the diagnosis wag rechecked and a new therapy was applied.Result Totally 125(47.0%)patients received final diagnoses of cough variant asthma(CVA),58(21.8%)was CVA and upper airway cough syndrome(UACS),44(16.5%)was diagnosed postinfection cough,35 (13.2%)of UACS.In different age groups,the proportion of incidence of etiological agents is statistically distinct.In the≤3 years old group,35 patients(70.0%)were diagnosed CVA,10(20.0%)was postinfection cough;in 3-6 years group,71 patients(50.7%)had CVA;the incidence of UACS was significantly higher in≥6 years group.Conclusion It is concluded that CVA,CVA and UACS,post infection cough,and simple UACS were identified as the three top reasons for children with chronic cough in Chongqing.Children with chronic cough of different age groups had different etiology of cough.The characteristic of each etiology need further study.