南宁地区儿童非特异性慢性咳嗽的病因构成和临床特征

Etiology and clinical characteristics of nonspecific chronic cough in children of Nanning

目的:探讨南宁地区儿童非特异性慢性咳嗽病因构成和临床特征,为临床诊治提供参考。方法:选取2016年6月至2019年6月在南宁市妇幼保健院呼吸专科就诊的慢性咳嗽初诊患儿659例作为研究对象,根据年龄分为婴幼儿组、学龄前期组、学龄期组,按照慢性咳嗽诊断标准对所有患儿进行诊断明确病因,对不同年龄组、不同性别间病因分布进行统计学分析。结果:单病因581例,占88.2%,其中,咳嗽变异性哮喘(CVA)219例,占33.2%;感染后咳嗽(PIC)180例,占27.3%;上气道咳嗽综合征(UACS)142例,占21.6%;变应性咳嗽(AC)23例,占3.5%;胃食管反流性咳嗽(GERC)12例,占1.8%;心因性咳嗽(PC)5例,占0.8%。双病因66例,占10.0%,其中CVA+UACS 45例(6.8%),PIC+UACS 21例(3.2%)。病因不明12例,占1.8%。不同年龄组主要病因构成比有所不同,婴幼儿组PIC 130例(46.6%),CVA 81例(29.0%),UACS 37例(13.3%);学龄前期组CVA 72例(39.8%),PIC 38例(20.9%),UACS 22例(12.1%);学龄期组UACS 83例(41.7%),CVA 66例(33.2%),CVA+UACS 22例(11.1%),3种主要病因的各年龄组构成比比较,差异有统计学意义(P>0.05)。结论:南宁地区儿童非特异性慢性咳嗽前3位主要病因为单病因中的CVA、PIC、UACS,且不同年龄组病因构成比不同;3组中男、女性别不同的儿童非特异性慢性咳嗽的病因构成无明显差异。

Objective:To explore the etiological composition and clinical characteristics of non-specific chronic cough in children of Nanning,so as to provide reference for clinical diagnosis and treatment.Methods:A total of 659 children with chronic cough who were first diagnosed in our hospital from June 2016 to June 2019 were divided into infant group,preschool group and school age group.The etiology of all children was diagnosed according to the diagnostic criteria of chronic cough,and the etiological distribution of different age groups and genders was statistically analyzed.Results:581 cases(88.2%)had single cause,including 219 cases of cough variant asthma(CVA)(33.2%),180 cases of post-infection cough(PIC)(27.3%),142 cases of upper airway cough syndrome(UACS)(21.6%),23 cases of allergic cough(AC)(3.5%),12 cases of gastroesophageal reflux cough(GERC)(1.8%),and 5 cases of psychogenic cough(PC)(0.8%).66 cases(10.0%)had double causes,including 45 cases of CVA+UACS(6.8%)and 21 cases of PIC+UACS(3.2%).12 cases(1.8%)had unknown causes.The composition ratios of the main causes were different in different age groups.There were 130 cases of PIC in infant group(46.6%),81 cases of CVA(29.0%),37 cases of UACS(13.3%).There were 72 cases of CVA in preschool group(39.8%),38 cases of PIC(20.9%),22 cases of UACS(12.1%).There were 83 cases of UACS in school age group(41.7%),66 cases of CVA(33.2%),22 cases of CVA+UACS(11.1%).There was significant difference in the ratio of the three main causes among different age groups(P>0.05).Conclusion:The first three main causes of nonspecific chronic cough in children of Nanning are CVA,PIC and UACS of single cause,and the etiological constituent ratio is different among different age groups,but there is no significant difference in the etiological composition of non-specific chronic cough between male and female children in the three groups.