武汉地区儿童慢性咳嗽病因分析及临床特征  

Spectrum and Clinical Feature of Children with Chronic Coughs in Wuhan Area of China

作　　者：陈江南[1] 刘苗[1] 梁章武[1] 王莹莹[1] 姜毅[1] 

机构地区：[1]武汉大学人民医院儿科,湖北武汉430060

出　　处：《武汉大学学报（医学版）》2013年第6期891-894,共4页Medical Journal of Wuhan University

摘　　要：目的:对武汉地区儿童慢性咳嗽的常见病因及临床特征进行研究,分析其对各病因的诊断价值。方法:收集2011年1月-2012年12月在儿科就诊的慢性咳嗽初诊患儿273例,遵循国内儿童慢性咳嗽诊断与治疗指南作出慢性咳嗽最终诊断。结果:273例患儿中符合入选标准者156例,能够配合完成整个慢性咳嗽病因诊断程序者132例,病因诊断率为87.12%,其中单一病因者104例,占78.79%;双重病因者16例,占12.12%;病因不明者12例,占9.09%。儿童慢性咳嗽的常见病因排名前4位分别是咳嗽变异性哮喘(25.76%)、上气道咳嗽综合征(21.21%)、感染后咳嗽(17.42%)、胃食管反流性咳嗽(9.85%)。咳嗽变异性哮喘的临床特征以夜间干咳为主;上气道咳嗽综合征临床特征以日间湿咳为主,并且常有鼻后滴流现象;感染后咳嗽患儿常有呼吸道疾病史;胃食管反流性咳嗽患儿,咳嗽常与进食及反流相关。结论:武汉地区儿童慢性咳嗽的常见病因依次为咳嗽变异性哮喘、上气道咳嗽综合征、感染后咳嗽和胃食管反流性咳嗽。各种病因的慢性咳嗽具有一定的临床特征,可为经验性诊治儿童慢性咳嗽提供临床依据。Objective： To explore the spectrum and clinical feature of children with chronic coughs in Wuhan area, and to analyze its value in etiological diagnosis. Methods： A total of 273 children with chronic coughs were recruited in Dept. of Pediatric, Renmin Hospital of Wuhan University between Jan 2011 to Nov 2012. The diagnosis was made according to Chinese Guideline for Di- agnosis and Treatment of Chronic Cough in Pediatrics published in 2008. Results： Of the 273 children, 156 cases meet the criteria, and 132 cases completed the whole etiology diagnosis. The etiological results showed 104 （78.79%） patients with single cause, 16 （12.12%） patients with double causes, and 12（9.09%） patients with unknown causes. The first four causes of chronic cough were as follows： cough variant asthma （CVA, 25.76%）, upper airway cough syndrome （UACS, 21. 21%）, post-infection cough （PIC, 17. 42%）, and gastroesophageal reflux cough （GERC, 9.85%）. The clinical feature of CVA is nighttime dry cough, while UACS is character- ized by wet phlegm cough in the daytime and usually with postnasal drip. PIC usually has a histo- ry of respiratory disease. GERC associates with reflux. Conclusion： It is concluded that in Wuhanarea, CVA, UACS, PIC, and GERC were identified as the four top causes for children with chronic cough. The sepecial clinical features were helpful for the etiological diagnosis.

关 键 词：儿童 慢性咳嗽 病因 临床特征 

分 类 号：R725.6[医药卫生—儿科]