北京地区儿童慢性咳嗽病因构成比研究

Ratio of cause constituentin children with chronicough in Beijing

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人性变应原阳性为主。1例患儿24h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％），UACS28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。

Objective To understand the causeand the ratio of cause constituentin children with chronicough in Beijing. MethodPatientwith chronicough treated arespiratory cliniof the Children＇ Hospital Affiliated to Capital Institute of Pediatricfrom May 2009 to April 2011 were included in thistudy. Etiologidiagnostiprocedure suggested fochildren by the Subspecialty Group of Respiratory Diseases, the Society of Pediatrics, Chinese Medical Association in 2008 waimplemented to manage the patients. Aftethree - month follow - up, the etiological datwaanalyzed. ResultTotally 213 patientwith chronicough aged 1.1 to 14.0 yearold were enrolled, inclu- ding 40 case（ 18.8% ） aged ≤ 3 yearold, 134 case（62.9%） aged 〉 3 to 6 yearold, and 39 case（ 18.3% ） aged 〉 6 yearold. The majority of patientwith positive allergen testwere sensitized to inhaled allergens. One child had positive resulin 24 - houesophageal pH monitoring, buhicough didn＇respond well to the specifitreatmenfogastroesophageal reflux,so he wasn＇diagnosed agastroesophageal reflux cough. The 4 leading causeof the 213 pa- tientwith chronicough were cough varianasthm（CVA） in 92 case（43.2%）, Cvassociated with uppeairway cough syndrome （UACS） in 57 case（26.8%）,UACin 28 case（13.2%）,respiratory infection and post- infec- tion cough （PIC） in 26 case（12.2%） ,while othecausewere found in 8 case（3.7%） ,and unknown etiology in 2 case（0.9%）. The incidence of Cvranked top 1 in all the 3 age groups,followed by Piin ~〈3 yearold group, while Cvassociated with UACin the othe2 age groups. ConclusionCVA, Cvassociated with UACS, UACand Piwere the 4 leading causefochildren with chronicough in Beijing. Children in differenage grouphad dif- ferenconstituentratio of causeof chronicough.