【摘要】 目的探讨高渗盐水诱导痰细胞学检查在儿童慢性咳嗽病因诊断中的意义。方法选择2007年1月至2007年12月广州医学院第一附属医院儿科门诊及住院的198例慢性非特异性咳嗽患儿,参考2006年ACCP《儿童慢性咳嗽临床循证实践指南》的诊断程序进行病因诊断,所有患儿均进行高渗盐水诱导痰细胞学检查,比较不同病因的慢性咳嗽儿童诱导痰细胞学分类的差异。同时选择159名健康儿童作为对照。结果 198例慢性咳嗽患儿中有175例痰诱导成功,成功率为88.4%,不良反应发生率为10.1%,主要表现为咽痒、恶心、咳嗽、头晕,停止诱导后可缓解。对175例痰诱导成功的慢性咳嗽患儿病因进行分析,获得明确诊断的有164例(93.7%),分别是咳嗽变异性哮喘(CVA)65例(37.1%)、上气道咳嗽综合征(UACS)52例(29.7%)、感染后咳嗽(PIC)37例(21.1%)、嗜酸粒细胞性支气管炎(EB)4例(2.3%)、胃食管反流性咳嗽(GERC)4例(2.3%)、肺结核(TB)1例(0.6%)、气道异物1例(0.6%),病因未明11例(6.3%)。CVA、UACS、PIC是本组慢性咳嗽患儿最常见的病因。按年龄分为三组,Ⅰ组(4～6岁)51例(29.1%),Ⅱ组(7～11岁)66例(37.7%),Ⅲ组(12～14岁)58例(33.1%)。不同年龄组病因分布差异无统计学意义(P>0.05)。不同病因组与正常对照组,以及不同病因组之间诱导痰细胞学分类差异有统计学意义(P<0.05)。结论在儿童开展高渗盐水诱导痰细胞学检查是安全和成功率较高的检测手段,对儿童慢性咳嗽病因诊断起着重要作用。更多还原

【Abstract】 Objective To explore the diagnostic significance of differential cell count in induced sputum to chronic cough in children.Methods A totle of 198 children with chronic cough in outpatient and inpatient departments of the First Affiliated Hospital of Guangzhou Medical College from January 2007 to December 2007 were included.The causes were investigated by using the guidelines for evaluating chronic cough in pediatrics(ACCP).The differential cell counts were measured and observed in induced sputum of these children with different causes to chronic cough.Results Sputum induction produced an adequate sample in 175 subjects,the success rate was 88.4%.The side effects including pharynx itching,nausea,cough and dizziness ect were found in 10.1% patients.The causes of 175 children with chronic cough were analyzed.These children were divided into 3 groups base on age.The children of groupⅠwas 4～6 years(51 cases),group Ⅱwas 7～11 years(66 cases),group Ⅲ was 12～16 years(58 cases).The distribution of causes of chronic cough were no significant differences among groupⅠ,Ⅱand Ⅲ(P>0.05).The differential cell counts in induced sputum were significant differences in each group of different diagnoses(P<0.05).The differential cell counts in induced sputum were significant differences between group of different diagnoses and the healthy controls(P<0.05).Conclusions Induced sputum procedure is a safe and effective method.The differential cell count in induced sputum to chronic cough in children has important diagnostic significance.更多还原