217例儿童慢性咳嗽病因构成及临床特征研究

目的 了解蚌埠地区儿童慢性咳嗽病因构成并分析常见临床特征在各病因组间的分布。 方法 选取2017年6月—2019年5月在蚌埠医学院第一附属医院儿科门诊就诊的217例慢性咳嗽患儿,参考中华医学会制定的《中国儿童慢性咳嗽诊断与治疗指南(2013年修订)》的诊断程序进行慢性咳嗽病因诊断并记录其临床特征,采用χ2检验进行统计学处理,分析儿童慢性咳嗽的病因构成及临床特征。 结果 217例完成随访的病例中,病因构成前4位依次为上气道咳嗽综合征61例(28.1%)、咳嗽变异性哮喘54例(24.9%)、上气道咳嗽综合征合并咳嗽变异性哮喘37例(17.1%)、感染后咳嗽35例(16.1%)。不同年龄段病因分布并不完全相同(χ2=31.718,P<0.05);~3岁组慢性咳嗽主要病因为感染后咳嗽(31.5%),~6岁组主要病因为上气道咳嗽综合征(38.9%),~14岁组主要病因为咳嗽变异性哮喘(38.2%)。不同性别患儿病因构成差异有统计学意义(χ2=20.087,P<0.05);男患儿首位病因为上气道咳嗽综合征46例(35.4%),女患儿首位病因为感染后咳嗽22例(25.3%)。不同病因组间慢性咳嗽的主要临床特征分布不同(均P<0.05)。 结论 蚌埠地区儿童慢性咳嗽的前4位病因分别为上气道咳嗽综合征、咳嗽变异性哮喘、咳嗽变异性哮喘合并上气道咳嗽综合征、感染后咳嗽;不同年龄、性别间慢性咳嗽病因构成不同;各病因组间慢性咳嗽临床特征分布不同,可为病因诊断提供参考。 

Ratio of component causes and clinical features of chronic cough:a report of 217 cases

Objective To investigate the ratio of component causes in children with chronic cough in Bengbu city and analyze the distribution of the common clinical features of chronic cough among different causes. Methods A total of 217 children with chronic cough were selected from the pediatric clinic of the First Affiliated Hospital of Bengbu Medical College from June 2017 to May 2019. The etiological diagnosis was made by referring to the Etiologic diagnostic procedure suggested for children by the Chinese Medical Association in 2013 and the clinical characteristics of the children were recorded. Chi-square test was used to analyze the etiological and clinical characteristics of chronic cough in children. Results Among the 217 cases who completed follow-up, the top four causes were upper airway cough syndrome(61 cases, 28.1%), cough variant asthma(54 cases, 24.9%), upper airway cough syndrome with cough variant asthma(37 cases, 17.1%), and post-infection cough(35 cases, 15.7%). The etiology of chronic cough in different age groups was not identical(χ2=31.718, P<0.05); The main etiology of chronic cough in 0-3 years old group was post-infection cough(31.5%), in 4-6 years old group was upper airway cough syndrome(38.9%) and in 7-14 years old group was cough variant asthma(38.2%). There was significant difference in etiologic components between male and female children(χ2=20.087, P<0.05); The primary cause in male children was upper airway cough syndrome(46 cases, 35.4%) and in female children was post-infection cough(22 cases, 25.3%). The distribution of main clinical features of chronic cough among different etiologic groups was different(all P<0.05). Conclusion The top four causes of chronic cough in children in Bengbu area are upper airway cough syndrome, cough variant asthma, cough variant asthma with upper airway cough syndrome, and post-infection cough. The etiologic components are different among different ages and sexes. The distribution of clinical characteristics among different causes are different, which can provide reference for etiologic diagnosis.