探讨不同年龄儿童慢性咳嗽病因构成和高危因素

Proportion of etiological agents and high risk factors in children with chronic cough at different ages

目的探讨不同年龄儿童慢性咳嗽病因构成和高危因素。方法选取慢性咳嗽患儿182例(试验组),根据年龄不同,将患儿分为婴儿组、幼儿组、学龄前组和学龄组。同时,选取同期非慢性咳嗽有咳嗽症状的患儿112例为对照组。比较实验组和对照组发病因素的差异,同时比较分析不同年龄试验组患儿确定的病因构成和感染的病原学特征。结果与对照组相比,试验组患儿过敏史、既往呼吸道疾病住院史、烟草暴露因素、空气污染因素、房屋异味因素、接触动物皮毛因素和冬春季发病率显著增加(P<0.05)。不同年龄组患儿慢性咳嗽病因构成具有显著性差异(χ2=66.085,P<0.01);婴儿组首位病因为呼吸道感染和感染后,幼儿组为咳嗽变异性哮喘,学龄前组为呼吸道感染和感染后,学龄组为上气道咳嗽综合征。感染后咳嗽患儿的病原学有一定年龄特征性,婴儿组主要为呼吸道合胞病毒和革兰阴性细菌感染,幼儿组主要为革兰阴性细菌感染,学龄前组和学龄组主要为肺炎支原体和肺炎衣原体感染。结论儿童慢性咳嗽病因复杂,有一定年龄的特征性;过敏史、既往呼吸道疾病住院史和生活环境因素可能为儿童慢性咳嗽发生的高危因素。

Objective To investigate the proportion of etiological agents and high risk factors in children with chronic cough at different ages. Methods One hundred and eighty two children with chronic cough （the study group） were selected. According to different ages, all the children were divided into four groups （the infants group, the young children group, the preschool group and the school group）. Meanwhile, 112 children with non-chronic cough were selected as the control group. The results were compared. Results Compared with the control group, the factors of allergies history, respiratory disease hospitalization history, exposure to tobacco, air pollution, house odor and contact animal coat were increased signifi cantly in the study group （P 〈 0.05）. The proportion of etiological agents was statistically distinct in different ages （X^2=66.085, P 〈 0.01）. The first etiology were respectively postinfeetion cough, CVA, postinfection cough and UACS in the infants group, the young children group, the preschool group and the school group. The characteristics of etiology in postinfection cough children at different ages were found. The major etiology was respectively RS virus, Gram-negative bacterium, MP and CPn in the infants group, the young children group, the preschool group and the school group. Conclusion Children with chronic cough of different age groups had different etiology. Allergies history, respiratory disease hospitalization history and living environment maybe are the high risk factors in children with chronic cough.