Clinical Study On The Common Causes Of Chronic Cough In Children And Related Inflammatory Factors

Objective: To understand the common etiology of chronic cough in children,the relationship between common causes of chronic cough and the levels of blood and airway inflammatory factors,and to observe the correlation between blood leukotrienes and fractional exhaled nitric oxide(FeNO);Provide a basis for cough diagnosis,differential diagnosis and treatment.Methods:A retrospective study was conducted to select children diagnosed with chronic cough in the Dalian children’s Hospital from December 2012 to December 2017.According to the common etiology diagnosis group,children with congenital respiratory diseases,sexual heart disease and poor compliance were excluded.According to the contents of the case collection form,their number,name,age,personal allergy history,family history of allergies,etc.were registered,the levels of FeNO,serum leukotrienesand serum total IgE were recorded,the common causes of chronic cough and the above indicators were analyzed and summarized.Result:1.Among the 170 children with chronic cough who met the inclusion criteria,UACS,PIC,CVA and GERC were common causes,124 cases with single cause,accounting for 72.94%;44 cases with double cause,accounting for 25.89%;2 cases with triple cause,accounted for 1.17%.2.Among the 170 children with chronic cough who met the inclusion criteria,216 cases were obtained,of which 92 cases were UACS,accounting for 42.59%,67 cases were PIC,accounting for 31.02%,and 53 cases were CVA,accounting for 24.54%.GERC had 4 cases,accounting for 1.85%,the highest cases were in the UACS group.3.Among the 216 cases of etiological diagnosis that met the inclusion criteria,according to the age group,7 cases were in the 0～1 year old group,accounting for3.24%,38 cases in the ～3 year old group,accounting for 17.59%,and 142 cases in the～6 year old group,accoutin for 65.74%,～14 years old 29 cases,accounting for 13.43%;The common causes of different age groups are different.In the 0～1 year old group,the main causeswere GERC,accounting for 57.14%,the main causes of the ～3 year old group were PIC,accounting for 42.11% and in the ～6 year old group and the ～14 year old group were UACS,accounting for 47.89% and 55.17% respectively.4.Among the 212 etiology diagnoses that met the inclusion criteria,81 cases were positive for personal allergy history,the positive rate was 38.21%;56 cases were positive for family allergy history,the positive rate was 26.42%;212 cases of etiological diagnosis,there were 148 cases of total IgE,and 97 cases of total IgE were positive,with an abnormal rate of 66.22%.In the common etiology of chronic cough,the positive rates of personal allergy history in children in CVA group,PIC group and UACS group were: 58.49%,31.52% and 31.87%,?2=12.314,P<0.05,the difference was statistically significant;The positive rates of family allergy history in the group were 39.62%,22.39%,and 21.74%,?2=6.350,P<0.05,which was statistically significant.Total IgE in children in CVA,PIC,and UACS groups the positive rates were 85.37%,53.19%,and61.67%,and ?2=10.707,P<0.05,which was statistically significant.5.Among the 212 etiology diagnoses that met the inclusion criteria,159 cases completed serum leukotriene test,100 cases increased,the abnormal rate was 62.89%;serum leukotrienes in CVA group,PIC group and UACS group The positive rates were:62.86%,70.91% and 56.52%.Compared with the positive rates of the three groups,? 2=2.764,P>0.05,the difference was not statistically significant.Among the 212 etiology diagnoses that met the inclusion criteria,192 cases completed the FeNO test,81 cases were increased,and the abnormal rate was 42.19%.The positive rates of FeNO in CVA group,PIC group and UACS group were 65.91%,32.79% and 36.78%,compared the positive rates of the three groups,?2=13.404,P<0.05,the difference wasstatistically significant.6.Among the 212 etiology diagnoses that met the inclusion criteria,123 were completed simultaneously with serum leukotrienes and FeNO.After Spearman correlation analysis,P>0.05,the two monitoring methods were not relevant.Conclusion:1.The common cause of chronic cough is single disease,the most common are UACS,PIC and CVA,and the high age group is 3-6 years old.2.Compared with the UACS and PIC groups,the CVA group had the highest personal,family allergic history and total IgE positive rate.3.The levels of inflammatory factors in blood and airways of children with CVA,PIC and UACS increased to varying degrees.In the CVA group,more than 60% of children had elevated levels of blood and airway inflammatory factors,with the highest positive rate.4.Serum leukotrienes and FeNO play an important role in monitoring the levels of inflammatory factors in the common causes of chronic cough,but the evaluation angles are different.The two monitoring methods are not relevant and cannot be replaced.