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儿童慢性湿性咳嗽病因构成比多中心研究

A multicenter clinical study on the cause constituent ratio of chronic wet cough in children

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【作者】 陈强胡次浪申昆玲贾春梅刘恩梅沈照波张建华覃敏郭彤华山殷勇刘红霞孙萍唐素萍胡晓光董晓艳刘瀚旻沙莉李晶郑湘榕韩志英吴星东徐迎春郝创利宋瑜欣安淑华陈艳萍

【Author】 CHEN Qiang;Chronic Cough Collaboration Group of Respiration Group of Pediatrics Branch of Chinese Medical Association;Clinical Research Collaboration Group on the Cause Constituent Ratio of Chronic Wet Cough in Children;

【通讯作者】 陈强;

【机构】 中华医学会儿科学分会呼吸学组慢性咳嗽协作组儿童慢性湿性咳嗽病因构成比研究协作组江西省儿童医院南昌大学附属儿童医院首都医科大学附属北京儿童医院包头市第四医院重庆医科大学附属儿童医院郑州大学附属儿童医院上海交通大学医学院附属新华医院广西壮族自治区妇幼保健院深圳市妇幼保健院安徽省儿童医院上海交通大学医学院附属上海儿童医学中心南京医科大学附属儿童医院南昌大学第一附属医院福建省福州儿童医院温州医科大学附属第二医院育婴儿童医院上海交通大学附属儿童医院四川大学华西第二医院首都儿科研究所附属儿童医院深圳市儿童医院中南大学湘雅医院山西省儿童医院厦门市妇幼保健院浙江大学医学院附属儿童医院苏州大学附属儿童医院哈尔滨市儿童医院河北省儿童医院湖南省儿童医院

【摘要】 目的了解中国儿童慢性湿性咳嗽的病因构成比,为儿童慢性湿性咳嗽的正确诊治提供指导。方法 2015年6月至2018年5月在全国17个省、自治区、直辖市共26所医院进行前瞻性儿童慢性湿性咳嗽的病因构成比研究,通过中国儿童慢性湿性咳嗽的问卷调查及3个月的治疗随访,了解我国儿童慢性湿性咳嗽的病因构成比。结果实际入组病例数1505例,合格病例1470例,合格率97.67%。位于病因构成比前4位的分别是上气道咳嗽综合征584例(39.73%)、哮喘合并上气道咳嗽综合征241例(16.39%)、哮喘合并感染164例(11.16%)、迁延性细菌性支气管炎151例(10.27%)。1岁以下患儿的首位病因是迁延性细菌性支气管炎(40.00%)。多病因的慢性湿性咳嗽有效病例数483例,占总病例数33.74%,其主要病因是哮喘合并上气道咳嗽综合征,占16.39%。华东、北方、南方3个地区首位病因均为上气道咳嗽综合征。其他病因在不同年龄的分布存在差异;不同病因在不同地区的分布也存在差异;同一种病因则呈现季节性变化。结论中国儿童慢性湿性咳嗽的主要病因依次为上气道咳嗽综合征、哮喘合并上气道咳嗽综合征、哮喘合并感染、迁延性细菌性支气管炎。1岁以下患儿首位病因是迁延性细菌性支气管炎。在不同年龄、不同地区和不同季节,儿童慢性湿性咳嗽病因构成比不尽相同。

【Abstract】 Objective To identify the causes of chronic wet cough in children in China and the constituent ratio of each cause so as to explore the most appropriate diagnosis procedure and treatment plan for children with chronic wet cough. Methods A prospective study was conducted between June 2015 and May 2018 in twenty-six hospitals in seventeen provinces,municipalities and autonomous regions;children with chronic wet cough were enrolled to identify the specific cause based on a questionnaire survey and then followed up in the next three months;all the data were collected and statistically analyzed to identify the constituent ratio of each cause. Results A total of 1505 cases were enrolled,of whom 1470 cases were qualified,the qualified rate being at 97.67%. The leading 4 causes were upper airway cough syndrome(UACS)with 584 cases(39.73%),asthma combined with UACS 241 cases(16.39%),asthma combined with infection 164 cases(11.16%),and PBB 151 cases(10.27%). In children aged<12 months,PBB ranked first(40.00%). There were 483 effective cases of chronic wet cough with multiple etiologies,accounting for 33.74% of the total cases;the main etiology among them was asthma combined with UACS,accounting for 16.39%. UACS is the primary cause of chronic wet cough in children in East China,North China and South China. Among other causes of chronic wet cough in children,the consituent ratio of each cause was different according to different ages and different regions,and even the same cause had different constituent ratio due to seasonal changes in the same region. Conclusion The main causes of chronic wet cough in Chinese children are UACS,asthma with UACS,asthma with infection and PBB. Children at different ages have different cause constituent ratio. For children aged<12 months,PBB ranks first. The constituent ratio of each cause is different in different ages,regions and seasons.

【关键词】 病因构成比慢性湿性咳嗽中国儿童
【Key words】 causeconstituent ratiochronicwet coughChinachild
【基金】 江西省科技厅重点研发项目(20177BBG70020);福棠儿童医学发展研究中心科研课题
  • 【文献出处】 中国实用儿科杂志 ,Chinese Journal of Practical Pediatrics , 编辑部邮箱 ,2019年09期
  • 【分类号】R725.6
  • 【被引频次】42
  • 【下载频次】839
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