儿童咳嗽变异性哮喘50例误诊分析

Analysis of 50 Misdiagnoses of Children Cough-variant Asthma

目的：探讨儿童咳嗽变异性哮喘(CVA)的病因、诊断及误诊。方法：对50例 CVA 患儿的临床资料进行回顾性分析。结果：男 性35例，女性15例。发作诱因：上呼吸道感染39例，气候变化15例，运动后6例，吸入冷空气后21例，同时具备2种以上诱因21 例。误诊为气管或支气管炎36例，上呼吸道感染25例，支原体感染18例，慢性咽炎10例，百日咳或类百日咳综合征4例，免疫功能 低下9例。抗生素治疗无效。结论：CVA 以慢性持续性干咳为其临床表现，运动、冷空气或上呼吸道感染可使咳嗽加重，支气管舒张 剂治疗有效。仔细询问病史，减少误诊。

Objective： To study the causes, diagnoses and misdiagnoses of children cough-variant asthma. Methods：Clinical data of 50 cases with cough-variant asthma （CVA） were reviewed retrospectively. Results： Among the 35 cases 35 were male, 15 were female. The triggers were. Upper respiratory airway infection 39 cases, the climatic change 15 cases, exercise 6 cases, and cold air 21 cases. 21 cases have more than two above causes. Among these 50 misdiagnoses, 36 were misdiagnoses as bronchitis, 25 as upper respiratory airway infection, 18 as mycoplasmal infection, 10 as chronic pharyngitis, 4 were misdiagnoses as whooping cough or whooping cough syndrome, 9 as low immune function. Antibiotic treatment has no effect on CVA syndromes. Conclusion：The main clinical manifestation of CVA is chronic and longlasting dry cough, exercise, cold air or upper respiratory airway infection may aggravate the cough. The bronchial tube dilator can reduce the syndrome. Doctors need to inquiry medical history carefully in order to avoid misdiagnoses.