中华实用儿科临床杂志
中華實用兒科臨床雜誌
중화실용인과림상잡지
Journal of Applied Clinical Pediatrics
2015年
13期
1023-1025
,共3页
耿凌云%陈慧中%刘传合%黄荣妍
耿凌雲%陳慧中%劉傳閤%黃榮妍
경릉운%진혜중%류전합%황영연
儿童%慢性咳嗽%病因构成比
兒童%慢性咳嗽%病因構成比
인동%만성해수%병인구성비
Child%Chronic cough%Ratio of causes constituents
目的：了解北京地区引起儿童慢性咳嗽的病因构成比。方法根据中华医学会儿科学分会呼吸学组2008年制定的《儿童慢性咳嗽诊断与治疗指南（试行）》的诊断标准和诊疗流程，对2009年5月至2011年4月在首都儿科研究所附属儿童医院呼吸专业门诊就诊的慢性咳嗽患儿进行病因诊断，完成3个月随访后，分析病因构成。结果共纳入213例患儿，年龄1.1~14.0岁，其中≤3岁40例（18.8%），﹥3~6岁134例（62.9%），﹥6岁39例（18.3%）。变应原检测阳性者以吸入性变应原阳性为主。1例患儿24 h 食管下端 pH值监测阳性但特异性治疗效果不支持胃食管反流性咳嗽。病因构成比前4位依次为咳嗽变异性哮喘（CVA）92例（43.2%），CVA 合并上呼吸道咳嗽综合征（UACS）57例（26.8%），UACS 28例（13.2%），呼吸道感染和感染后咳嗽（PIC）26例（12.2%），其他病因咳嗽8例（3.7%），不明原因咳嗽2例（0.9%）。不同年龄组儿童慢性咳嗽的首位病因均为 CVA；第2位病因在≤3岁组为 PIC，在学龄前和学龄儿童组均为 CVA 合并 UACS。结论北京地区儿童慢性咳嗽的前4位病因依次为 CVA、CVA 合并 UACS、UACS 及 PIC，不同年龄组儿童慢性咳嗽的病因构成比有所不同。
目的：瞭解北京地區引起兒童慢性咳嗽的病因構成比。方法根據中華醫學會兒科學分會呼吸學組2008年製定的《兒童慢性咳嗽診斷與治療指南（試行）》的診斷標準和診療流程，對2009年5月至2011年4月在首都兒科研究所附屬兒童醫院呼吸專業門診就診的慢性咳嗽患兒進行病因診斷，完成3箇月隨訪後，分析病因構成。結果共納入213例患兒，年齡1.1~14.0歲，其中≤3歲40例（18.8%），﹥3~6歲134例（62.9%），﹥6歲39例（18.3%）。變應原檢測暘性者以吸入性變應原暘性為主。1例患兒24 h 食管下耑 pH值鑑測暘性但特異性治療效果不支持胃食管反流性咳嗽。病因構成比前4位依次為咳嗽變異性哮喘（CVA）92例（43.2%），CVA 閤併上呼吸道咳嗽綜閤徵（UACS）57例（26.8%），UACS 28例（13.2%），呼吸道感染和感染後咳嗽（PIC）26例（12.2%），其他病因咳嗽8例（3.7%），不明原因咳嗽2例（0.9%）。不同年齡組兒童慢性咳嗽的首位病因均為 CVA；第2位病因在≤3歲組為 PIC，在學齡前和學齡兒童組均為 CVA 閤併 UACS。結論北京地區兒童慢性咳嗽的前4位病因依次為 CVA、CVA 閤併 UACS、UACS 及 PIC，不同年齡組兒童慢性咳嗽的病因構成比有所不同。
목적：료해북경지구인기인동만성해수적병인구성비。방법근거중화의학회인과학분회호흡학조2008년제정적《인동만성해수진단여치료지남（시행）》적진단표준화진료류정，대2009년5월지2011년4월재수도인과연구소부속인동의원호흡전업문진취진적만성해수환인진행병인진단，완성3개월수방후，분석병인구성。결과공납입213례환인，년령1.1~14.0세，기중≤3세40례（18.8%），﹥3~6세134례（62.9%），﹥6세39례（18.3%）。변응원검측양성자이흡입성변응원양성위주。1례환인24 h 식관하단 pH치감측양성단특이성치료효과불지지위식관반류성해수。병인구성비전4위의차위해수변이성효천（CVA）92례（43.2%），CVA 합병상호흡도해수종합정（UACS）57례（26.8%），UACS 28례（13.2%），호흡도감염화감염후해수（PIC）26례（12.2%），기타병인해수8례（3.7%），불명원인해수2례（0.9%）。불동년령조인동만성해수적수위병인균위 CVA；제2위병인재≤3세조위 PIC，재학령전화학령인동조균위 CVA 합병 UACS。결론북경지구인동만성해수적전4위병인의차위 CVA、CVA 합병 UACS、UACS 급 PIC，불동년령조인동만성해수적병인구성비유소불동。
Objective To understand the causes and the ratio of cause constituents in children with chronic cough in Beijing. Methods Patients with chronic cough treated at respiratory clinic of the Children' s Hospital Affiliated to Capital Institute of Pediatrics from May 2009 to April 2011 were included in this study. Etiologic diagnostic procedure suggested for children by the Subspecialty Group of Respiratory Diseases,the Society of Pediatrics,Chinese Medical Association in 2008 was implemented to manage the patients. After three - month follow - up,the etiological data was analyzed. Results Totally 213 patients with chronic cough aged 1. 1 to 14. 0 years old were enrolled,inclu-ding 40 cases(18. 8% )aged≤3 years old,134 cases(62. 9% )aged ﹥ 3 to 6 years old,and 39 cases(18. 3% ) aged ﹥ 6 years old. The majority of patients with positive allergen tests were sensitized to inhaled allergens. One child had positive result in 24 - hour esophageal pH monitoring,but his cough didn't respond well to the specific treatment for gastroesophageal reflux,so he wasn't diagnosed as gastroesophageal reflux cough. The 4 leading causes of the 213 pa-tients with chronic cough were cough variant asthma(CVA)in 92 cases(43. 2% ),CVA associated with upper airway cough syndrome(UACS)in 57 cases(26. 8% ),UACS in 28 cases(13. 2% ),respiratory infection and post - infec-tion cough(PIC)in 26 cases(12. 2% ),while other causes were found in 8 cases(3. 7% ),and unknown etiology in 2 cases(0. 9% ). The incidence of CVA ranked top 1 in all the 3 age groups,followed by PIC in ≤3 years old group, while CVA associated with UACS in the other 2 age groups. Conclusions CVA,CVA associated with UACS,UACS and PIC were the 4 leading causes for children with chronic cough in Beijing. Children in different age groups had dif-ferent constituents ratio of causes of chronic cough.
