刘霞 蒲荣 沈红 祁生贵 曹戌

*基金项目：青海省卫生健康委员会科研项目（2020-wjzdx93）

【摘要】 目的：分析高原地区儿童慢性咳嗽病因构成及临床特征。方法：选取2020年1月—2022年12月青海省妇女儿童医院收治的慢性咳嗽患儿262例为观察组，再选择本院同期呼吸道感染患儿50例为对照组，比较对照组与观察组临床资料，比较观察组不同年龄、性别、季节、咳嗽性质、咳嗽时相儿童慢性咳嗽病因构成。结果：262例患儿中，咳嗽变异性哮喘（CVA）60例（22.90%），上气道咳嗽综合征（UACS）55例（20.99%），感染后咳嗽（PIC）77例（29.39%），过敏性咳嗽（AC）27例（10.31%），胃食管反流性咳嗽（GERC）24例（9.16%），心因性咳嗽（PC）6例（2.29%），抽动秽语综合征（TS）13例（4.96%）。A组以UACS、PIC、CVA为主；B组以PIC、UACS及CVA为主；C组以CVA、GERC及PIC为主。三组各病因比较，差异均有统计学意义（P<0.05）。262例患儿中，男童138例（52.67%），女童124例（47.33%），两组各病因比较，差异均无统计学意义（P>0.05）。262例患儿中，春季63例（24.05%），夏季55例（20.99%），秋季43例（16.41%），冬季101例（38.55%），春季以UACS、PIC为主，夏季以CVA、UACS为主，秋季以PIC为主，冬季以CVA、UACS、PIC为主。262例患儿中，干咳135例（51.53%），湿咳为127例（48.47%），干咳以UACS、PIC为主，湿咳以CVA为主。262例患儿中，晨咳以CVA为主，日咳以PIC为主，夜间咳嗽以CVA、UACS为主。结论：儿童慢性咳嗽的原因复杂，高原地区儿童慢性咳嗽病因前三位依次为CVA、UACS、PIC，不同年龄、季节、咳嗽性质、咳嗽时相的慢性咳嗽病因都不同。

【关键词】 高原地区 儿童慢性咳嗽 病因 临床特征

Analysis of Etiological Composition and Clinical Characteristics of Chronic Cough in Children in Plateau Area/LIU Xia， PU Rong， SHEN Hong， QI Shenggui， CAO Xu. //Medical Innovation of China， 2024， 21（14）： -138

[Abstract] Objective： To analyze the etiological composition and clinical characteristics of chronic cough in children in plateau area. Method： A total of 262 children with chronic cough admitted to Qinghai Province Women and Children's Hospital from January 2020 to December 2022 were selected as the observation group， and 50 children with respiratory tract infection during the same period in the hospital were selected as the control group. The clinical data of the control group and the observation group were compared， and the etiological composition of chronic cough in children with different age， gender， season， cough nature and cough phase in the observation group were compared. Result： Among the 262 children， 60 cases （22.90%） of cough variant asthma （CVA） ， 55 cases （20.99%） of upper airway cough syndrome （UACS）， 77 cases （29.39%） of post-infection cough （PIC）， 27 cases （10.31%） of allergic cough （AC）， 24 cases （9.16%） of gastroesophageal reflux cough （GERC）， 6 cases （2.29%） of psychogenic cough （PC）， 13 cases （4.96%） of Tourette syndrome （TS）. Group A mainly consisted of UACS， PIC and CVA， group B mainly consisted of PIC， UACS and CVA， group C mainly consisted of CVA， GERC and PIC. There were significant differences in etiology among the three groups （P>0.05）. Among the 262 children， 138 （52.67%） were boys and 124 （47.33%） were girls. There were no significant differences in etiology between the two groups （P>0.05）. Among the 262 children， 63 cases （24.05%） were found in spring， 55 cases （20.99%） in summer， 43 cases （16.41%） in autumn， and 101 cases （38.55%） in winter. UACS and PIC were predominant in spring， CVA and UACS were predominant in summer， PIC was predominant in autumn， CVA， UACS and PIC were predominant in winter. Among 262 cases， 135 cases （51.53%） of dry cough， 127 cases （48.47%） of wet cough， UACS was predominant in dry cough， PIC and CVA were predominant in wet cough. Among 262 children， CVA was predominant in morning cough， PIC was predominant in day cough， CVA and UACS were were predominant in night cough. Conclusion： The causes of chronic cough in children are complex， the top three causes of chronic cough in children in plateau areas are CVA， UACS and PIC in turn， and the causes of chronic cough are different in different age， season， cough nature and cough phase.

[Key words] Plateau area Chronic cough in children Etiology Clinical characteristics

First-author's address： Department of Pediatrics， Qinghai Province Women and Children's Hospital， Xining 810000， China

doi：10.3969/j.issn.1674-4985.2024.14.032

儿童慢性咳嗽以咳嗽为唯一症状，持续时间超过4周[1]。导致慢性咳嗽的原因有很多，常见原因为咳嗽变异性哮喘，约占慢性咳嗽发病的41.9%，另外，慢性咳嗽患儿往往伴有湿疹、过敏性鼻炎或家族史，以及上气道咳嗽综合征（upper airway cough syndrome，UACS）、鼻窦炎、腺样体肥大等，上呼吸道感染或下呼吸道感染后也可引起慢性咳嗽[2]。咳嗽……