Study On Etiology Of Chronic Cough In Children

Objective:In recent years, as a common symptom in children, chronic cough has aroused growing concerns among pediatricians.It has became a hot research both at home and abroad because of its complex causes and high rates of misdiagnosis. However, our systematic studies of children with chronic cough have just started, and still lack a lot of convinced epidemiological data, clinical data, laboratory data and treatment data as well as multi-center large sample randomized controlled research data. Therefore, relevant research in children with chronic cough should actively be carried out to provide more information for future meta-analysis and sum up evidence-based medical treatment recommendations. Based on the implementation of the above problems and ideas, we select some chronic cough children in Dalian Children Hospital in order to find out the distribution of the causes. Hopefully, it will provide scientific foundations for practical diagnosis. At the same time, data will be provided to nation-wide epidemiological research about the causes of chronic cough.Methods:A total of 68 children with chronic cough have been selected in Dalian Children Hospital from March 2009 to November 2009 as subjects for the study. With reference to Diagnosis and Treatment of Children with Chronic Cough Guide (Trial) published in 2008 by Pediatric Branch of Chinese Medical Association Study Group Respiratory, a questionnaire about children's chronic cough has been made to carry out prospective and descriptive studies by means of gradual observation, assessment and follow-up in order to analyze the causes of chronic cough.Results:1. Ages of the 68 children with chronic cough:infant group of 8 patients (11.8%), pre-school group of 35 patients (51.5%), school-age group of 25 patients (36.8%)2. The diagnosis conditions of 68 children with chronic cough:there were 63 final diagnosis, its rate 92.6%,4 suspected diagnosis, its rate 5.9%, and 1 undiagnosed patient, accounting for 1.5% of the total cases.Final diagnosis include 42 cases of one single cause,20 cases of double causes (second diagnosis confirmed in 15 cases,5 cases in suspected), and 1 case of triple cause.3. The constitution of etiology in 68 children with chronic cough:The total number of etiology is 91.Among these, there are 80 cases of final diagnosed causes (87.9%); 10 cases of suspected causes (11.0%); 1 case of undiagnosed cause(1.1%). The frequency sequence of causes:32 with the upper airway cough syndrome (35.2%); 28 with respiratory tract infection and postinfectious cough (30.8%); 26 with cough variant asthma (28.6%);4 with gastroesophageal reflux cough (4.4%) and 1 case of unknown etiology (1.1%).4. Different causes in the same age groups:(1)Infant group, the causes of the top three were:respiratory tract infection and postinfectious cough33.3%; cough variant asthma33.3%; gastroesophageal reflux cough25.0%.(2)Pre-school group, the causes of the top three were:upper airway cough syndrome 41.9%; respiratory tract infection and postinfectious cough 30.2%; cough variant asthma25.6%.(3)School-age group, the causes of the top three were:upper airway cough syndrome 37.1%; respiratory tract infection and postinfectious cough 31.4%; cough variant asthma 31.4%.5. The same cause in different age groups:(1)Upper airway cough syndrome:pre-school group 56.3%, school-age group 40.6%, infant group 3.1%.(2)Respiratory tract infection and postinfectious cough:pre-school group 46.4%, school-age group 39.3%, infant group 14.3%.(3)Cough variant asthma:both of pre-school and school-age group 42.3%, infant group 15.4%.(4)Gastroesophageal reflux cough:infant group 3/4 and pre-school group 1/4.Conclusion:1. Upper airway cough syndrome, respiratory tract infection and postinfectious cough, cough variant asthma and gastroesophageal reflux cough are the most common causes of chronic cough in children.2. Upper airway cough syndrome is the most common cause of chronic cough in pre-school group and school-age group.3. Respiratory tract infection and postinfectious cough run through the various stages of children with chronic cough. It is the first reason of infant group with chronic cough.Bacterial infection is also an important cause of chronic cough in respiratory tract infection and postinfectious cough4. Cough variant asthma is not the primary cause of chronic cough in children5. Gastroesophageal reflux cough should be significantly concerned in infant group with chronic cough.6. Following the guidelines of the diagnosis and treatment process, and also given attention to the common causes of chronic cough are very important for a pediatrician about the clinical diagnosis and treatment of chronic cough.