小儿慢性咳嗽的诊断探讨

Etiological diagnosis of chronic cough in children.

【目的】探讨小儿慢性咳嗽的病因及分布特点,为临床诊断慢性咳嗽提供依据。【方法】参考ABChang推荐的儿童慢性咳嗽诊断流程,并辅以诱导痰细胞分类检查,对慢性咳嗽的病因进行分类,并针对病因进行特异性治疗。【结果】用此方法对门诊61例慢性咳嗽患儿进行分析,其中咳嗽变异性哮喘(coughvariantasthma,CVA)占54.1％(33／61),鼻后滴漏综合征(postnasaldripsyndrome,PNDS)占24.6％(15／61),支原体感染占8.2％(5／61),双病因8.2％(5／61),病因未明4.9％(3／61),经过针对病因的特异性治疗,有91.6％(56／61)患者咳嗽症状明显减轻或消失。【结论】儿童慢性咳嗽常见病因有咳嗽变异性哮喘、鼻后滴漏综合征、支原体感染,针对病因治疗是临床疗效的关键。

[Objective] To explore the spectrum of causes for chronic cough in children. [Methods] 61 children with chronic cough were enrolled in the study. The diagnostic procedure was based on the protocol for diagnosing chronic cough designed by AB Chang and additional cytological assay was performed for sputum induced by hypertonic saline aerosol inhalation. The efficacy of specific therapy for etiology was evaluated. [Results] The most common causes included cough variant asthma (CVA) 54. 1%(33/61), postnasal drip syndrome (PNDS) 24. 6%(15/61), mycoplasma pneumoniae infection 8. 2%(5/61). After active management based on the etiology, cough improved in 56 patients (91. 6%). [Conclusion] The common causes for chronic cough in children included CVA, PNDS and Mycoplasma pneumoniae infection . A positive response to the specific therapy is essential to a definite diagnosis.