Khoshoo Vikram, Edell Dean, Mohnot Sopan, Haydel Robert, Saturno Emilio, Kobernick Aaron
West Jefferson Medical Center, New Orleans, LA.
West Jefferson Medical Center, New Orleans, LA.
Chest. 2009 Sep;136(3):811-815. doi: 10.1378/chest.09-0649. Epub 2009 Jun 30.
Children presenting with chronic cough are common to the primary care physicians, but data on the etiology are scant.
We evaluated 40 children (age range, 5 to 12 years) with chronic cough (> 8 weeks duration) with no obvious cause who were referred by their primary care physicians. All patients underwent an extensive multispecialty workup that included pulmonary, GI, allergy, immunology, and otorhinolaryngology testing. Response to treatment was quantified pretreatment and 8 weeks after treatment by using a visual analog scale.
Positive diagnostic test results were noted for gastroesophageal reflux disease (27.5%), allergy (22.5%), asthma (12.5%), infection (5%), aspiration (2.5%), and multiple etiologies (20%). Appropriate treatment for these factors resulted in a significant improvement in cough.
Reflux, allergy, and asthma accounted for > 80% of the likely etiologic factors of chronic cough in children and responded to appropriate treatment.
患有慢性咳嗽的儿童在基层医疗医生处很常见，但关于病因的数据却很少。
我们评估了40名（年龄范围5至12岁）由基层医疗医生转诊而来的慢性咳嗽（持续时间>8周）且无明显病因的儿童。所有患者都接受了广泛的多专科检查，包括肺部、胃肠道、过敏、免疫和耳鼻喉科检查。治疗反应通过视觉模拟量表在治疗前和治疗8周后进行量化。
胃食管反流病（27.5%）、过敏（22.5%）、哮喘（12.5%）、感染（5%）、误吸（2.5%）和多种病因（20%）的诊断测试结果呈阳性。针对这些因素进行适当治疗后，咳嗽有显著改善。
反流、过敏和哮喘占儿童慢性咳嗽可能病因的80%以上，且对适当治疗有反应。
