The Causes And Analysis Of Chronic Wet/Productive Cough In Children

Objective To analyse the causes of chronic wet cough in children.Methods Patients with chronic wet cough from March 2016 to March 2017 were included in this study.Etiological diagnosis suggested for children by the Su bspecialty Group of Respiratory Diseases,the Society of Pediatrics,Chinese Medi cal Association in 2013 was implemented to manage the patients.The patients,grouped by age,were divided into four groups.After 2,4 and 12 weeks of follow-up,the etiological data was analyzed.According to the multivariate logistic regression model,we used the single factor(p<0.05)as independent variable to diagnose and predict upper airway cough syndrome(UACS),post-infection cough(PIC),bronchial asthma(BA)uncontrolled and cough variant asthma(CVA).Results Among the 116 cases,113 were eligible(the passing rate of 97.41%).the children with chronic wet cough ranged from 4 months old to 13 years old,with an average duration of(8.50 ± 6.41)weeks.The number of single causes of chronic wet cough cases were upper airway cough syndrome(UACS)23 cases(20.35%),post-infection cough(PIC)22 cases(19.47%),bronchi al asthma(BA)uncontrolled 15 cases(13.27%),cough variant asthma(CVA)11 cases(9.73%),bronchial asthma(BA)combined infection 10 cases(8.85%),protracted bacterial bronchitis(PBB)7 cases(6.19%),and pertussis-like synd rome 3 cases(2.65%).The number of double causes of chronic wet cough we re UACS+CVA 9 cases(7.96%),UACS+BA uncontrolled 8 cases(7.08%),UAC S+PIC 2cases(1.78%),UACS+ BA combined infection 1cases(0.89%);The nu mber of triple causes of chronic wet cough were UACS+CVA+bronchiectasia 1cases(0.89%),UACS+BAcombined infection +PBB 1 cases(0.89%).The l eading causes of different groups are that PBB in?1years old group,PIC in?3years old group,UACS in ?4years old and?13years old groups.After 2 we eks of treatment,the symptom score of cough was decreased significantly,and disappeared at the end of the 12 th week.The diagnosis model of UACS was f requent throat,runny nose,nasal congestion,pharynx posterior wall follicular h yperplasis,family history of allergic rhinitis,AUC=0.8874;The diagnosis model of PIC were MP-Ig M positive,AUC=0.7723;The diagnosis model of BA uncontrolled was recurrent wheezing,eosinophils increased,indoor plants,AUC=0.9348;The diagnosis model of CVA was cough in the middle of the night,runn y nose,stuffy nose,indoor plants,MP-IgM negative.AUC=0.8435.The diagnos is of UACS included 71.11% of the patients with acute sinusitis.The most common sites were maxillary sinus(40.63%)and paranasal sinuses(40.63%),whi ch were mostly found in the 4~6 years old group.Over time,the compliance of the children were fluctuated,with a decrease in BA uncontolled,the proportion of compliance from 73.33% to 33.33%.Conclusion 1.The four leading causes for children with chronic wet cough were UACS,PIC,BA uncontrolled,CVA.2.Children in different ages or gender groups had different constituents of causes.3.Specific factors provide the basis for UACS,PIC,BA uncontrolled,and CVA.4.Sinusitis was the most common in UACS.The maxillary sinusitis was the most in sinusitis.5.PBB was more commonly in infants and young children;and the standards of clinical diagnosis were more convenient to implement and easy to be accepted by parents.6.It was necessary to establish electronic records and unify management for the children of BA.7.Chronic wet cough caused by pertussis-like syndrome,should not be ignored.