| Background:Cough is one of the most common symptoms in respiratory diseases of children. The causes of cough are complicated in clinical diagnosis, especially in children. Long-time treatment will impact the physical and mental health of children, and as an additional economic burden to their parents.In the past 20 years, multifaceted research has been carried out in European and American countries for causes, diagnosis and treatment in adults. Guidelines for diagnosis and treatment were formulated. In 2005, Society of Respiratory Disease, Chinese Medical Association worked out a similar Guideline for adults in Chinese. Evidence-based medicine suggested:causes of chronic cough in children are different from adults. The causes of chronic cough in different age-group are distinct. As a result, there should be a Guideline for children with chronic cough. In response, the Guidelines for children with chronic cough have been developed in the United States, Europe, Singapore, Australia and Japan and other countries[3-7]. The Guidelines of diagnosis and therapy for Chinese children with chronic cough were formulated by the Subspecialty Group, Society of Pediatrics, Chinese Medical Association and Chinese Journal of Pediatrics in 2007.CVA is a special type of asthma in which cough is the main or only clinical manifestation. It was confirmed [22]: CVA is the leading cause of chronic cough in children. The incidence of CVA is related with the season, personal allergic history and family history of asthma[23]. Inhaled corticosteroid is effective in early treatment. MP is the smallest microbe between bacteria and viruses ,nearly 200mm. It is the pathogen of mycoplasma pneumonia in human. Epidemiological and clinical evidence suggests: the infection of Mycoplasma pneumoniae in respiratory tract is related with potential deterioration of CVA.Objective:To investigate the proportion of incidence of children with non-specific chronic cough in Chongqing and analyze the characteristic of etiology during the follow-up. To research clinical symptom,laboratory examination and prognosis in children with cough variant asthma complicated with positive mycoplasma antibody in serum.Methods : Diagnostic criteria were defined for children with non-specific chronic cough according to the Guidelines of diagnosis and therapy for children with chronic cough that were formulated by the Subspecialty Group, Society of Pediatrics, Chinese Medical Association and Chinese Journal of Pediatrics in 2008. Totally 266 patients in whom cough was the main or the only symptom, lasting >4weeks, presenting to Asthma Center of Children's Hospital, Chongqing Medical University between June 2008 and April 2009 were recruited into this study. Based on the Guidelines, diagnosis was made after taking history, physical examination and assistant examination. After etiological treatment, the patients were followed up at the second week, the fourth week and the twelfth week. Etiological diagnosis was confirmed if cough was resolved after specific therapy. If cough was no resolved,the diagnosis was rechecked and a new therapy was applied.Results:1. We found 125(47.0%) patients received final diagnoses of cough variant asthma (CVA), 58(21.8%)was CVA and upper airway cough syndrome (UACS),44(16.5%)was diagnosed postinfection cough, 35 (13.2%) of upper airway cough syndrome (UACS).2. In different age groups, the proportion of incidence of etiological agents is statistically distinct. In≤3 years old group, 35 patients (70.0%) was diagnosed CVA, 10 (20.0%) was postinfection cough; in 3～6 years group, 71 patients (50.7%) wasCVA; the incidence of UACS was significantly higher in≥6 years group.3. In patients with CVA, Mycoplasma antibody was positive in 31.1%.4. The proportion of severe bronchial provocation test was higher in children with positive Mycoplasma antibody than negative. CVA in girls was more likely associated with positive MP antibody.5. The age, duration of cough in children with CVA may not be related with the results of his MP antibody. |
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