儿童慢性咳嗽279例常见病因与危险因素分析  

Analysis of common causes and risk factors of chronic cough in children:report of 279 cases

作　　者：翁泽林[1] 江文文[1] 郑燕霞[1] 许尤佳[1] WENG Zelin JIANG Wenwen ZHENG Yanxia XU Youjia(Department of Pediatrics, Guangdong Province Traditional Chinese Medical Hospital, Guangzhou 510120, China)

机构地区：[1]广东省中医院儿科,广州510120

出　　处：《疑难病杂志》2017年第2期172-176,共5页Chinese Journal of Difficult and Complicated Cases

基　　金：广东省中医药管理局2013年建设中医药强省科研课题(20132168)

摘　　要：目的分析儿童慢性咳嗽常见病因及其发病的危险因素。方法收集2012年11月—2015年10月广东省中医院儿科收治的慢性咳嗽患儿295例,剔除不符合入选标准患儿16例,将其余279例按照年龄分为3组:婴幼儿组(n=84)、学龄前期组(n=135)、学龄期组(n=60)。通过前瞻性临床研究方法,按照慢性咳嗽诊断程序作出病因诊断。根据临床资料等统计分析不同年龄组上气道咳嗽综合征(UACS)、咳嗽变异性哮喘(CVA)和呼吸道感染后咳嗽(PIC)等主要病因构成比。通过单因素分析确定3组不同病因之间构成具有差异的相关因素,通过多因素非条件Logistic回归分析UACS、CVA以及PIC发病的危险因素。结果 279例慢性咳嗽病因构成为:UACS 79例(28.31%),CVA 91例(32.62%),PIC 90例(32.26%),多病因19例(6.81%);婴幼儿组病因以PIC为主,学龄前期组三大病因构成比大致相同,学龄期组病因以CVA为主;通过慢性咳嗽常见病因分析表明性别、入托情况、烟草环境暴露等31个相关因素在不同病因组中差异具有统计学意义(P<0.05);通过多因素非条件Logistic回归分析表明,UACS危险因素包括家族成员吸烟(烟草环境暴露)、白天咳嗽、卧位时咳嗽、鼻塞等(P<0.05);CVA危险因素包括家族过敏性鼻炎病史、家族哮喘病史、冷空气或异味刺激、过敏原等(P<0.05);PIC危险因素包括气候变化因素、抗生素使用(P<0.05)。结论不同年龄组患儿慢性咳嗽病因构成不同,且相同病因在不同年龄段病程存在差异。UACS危险因素包括家族成员吸烟(烟草环境暴露)、白天咳嗽、卧位时咳嗽、鼻塞等,CVA危险因素包括家族过敏性鼻炎病史、家族哮喘病史、冷空气或异味刺激、过敏原等,PIC危险因素包括气候变化因素、抗生素使用。Objective To sum up the common causes of chronic cough in children,and to explore the risk factors of chronic cough.Methods Two hundred and ninety-five children with chronic cough who treated in Guangdong Province Traditional Chinese Medical Hospital from November 2012 to October 2015 were enrolled,and 16 cases were excluded from the inclusion criteria,the rest of patients with chronic cough were divided into 3 groups according to their age,including the infant group,the preschool group and the school age group.Through the prospective clinical research methods,diagnosis was made according to the diagnostic procedure of chronic cough.Through single factor analysis to determine the difference between the three groups of different causes of the relevant factors,through the multi factor non conditional Logistic regression analysis to explore the risk factors of UACS,CVA and PIC.Results 279 cases of chronic cough etiology：UACS 79 cases（28.31%）,CVA 91 cases（32.62%）,PIC 90 cases（32.26%）,19 cases（6.81%）;for sick infants were mainly caused by PIC,the constituent ratio of roughly the same of the 3 factors in preschool group,school- age mainly caused bv CVA.A common cause of chronic cough in the situation analysis showed that sex,tobacco,environmental exposure and 31 factors have significant difference in different etiology group（P〈0.05）;by multi factor non conditional Logistic regression analysis showed that UACS risk factors include family smoking（tobacco exposure）,daytime cough,decubitus cough and nasal obstruction（P〈0.05）;CVA risk factors include family history of allergic rhinitis,family history of asthma,cold air or odor stimulation,allergens（P〈0.05）;PIC＇s risk factors including climate change factors and antibiotic use（P〈0.05）.Conclusion The etiology of chronic cough was different in different age groups,and the same causes were different in different age groups.The clinical features can provide clues for the diagnosis of chronic cough.UACS risk factors,including family

关 键 词：慢性咳嗽 病因 危险因素 儿童 LOGISTIC回归分析 

分 类 号：R725.6[医药卫生—儿科]