| Objective:To understand the causes of chronic cough in children in Tianjin and the composition ratio of the distribution.To explore the relationship between the etiology of children’s chronic cough and factors such as age,gender,region,season and other factors,to provide diagnostic basis for clinicians to identify the etiology in the early stage,reduce the risk of complications of children and reduce the economic burden caused by repeated visits.Method:This survey is a retrospective study.315 eligible cases of children with chronic cough were selected from the pediatric clinic of the second hospital of Tianjin Medical University from August 2015 to November2019.The cough symptoms of the children lasted for more than 4 weeks,the age was ≤ 14 years old,the lung had no positive signs,the chest X-ray film was normal.Their parents were informed and willing to accept the outpatient follow-up and / or telephone follow-up,to cooperate with the completion of the study.According to the 2014 Guideline for diagnosis and treatment of chronic cough in pediatrics formulated by Respiratory science group of pediatrics society of Chinese medical association,editorial board of Chinese journal of pediatrics.Except for those with obvious abnormality of chest X-ray film and / or those with serious systemic diseases and / or those who are unwilling or unable to cooperate to complete the study.Result:1.The leading 3 causes were upper airway cough syndrome(UACS)in 131cases(41.6%),cough variant asthma(CVA)in 81 cases(25.7%),UACS associated with CVA in 51 cases(16.2%).Athma in 25 cases(7.9%),respiratory infections and post-infectious cough(PIC)in 18 cases(5.7%),allergic cough(1.9%)in 6 cases(1.9%).Multiple etiologies in 54cases(17.1%),the leading cause in UACS associated with CVA,which accounted for 94.4%,followed by PIC with UACS accounting for 5.6%.2.In all cases,261(82.9%)chronic coughs were caused by single cause,54(17.2%)by multiple etiologies.There were 151 cases(57.8%)of dry cough and 110 cases(42.2%)of wet cough.The top 3 causes of children with dry cough were CVA in 60 cases(41.1%),UACS in 46 cases(31.5%)and asthma in 23 cases(15.8%).The top 3 causes of children with wet cough were UACS in 85 cases(77.3%),CVA in 21 cases(19.1%)and asthma in 2cases(1.8%).The difference in the etiological composition of children with dry cough and wet cough was statistically significant(p<0.05).3.Related factors of chronic cough in children(1)Relationship with age: among 315 children with chronic cough,215(68.3%)were in the infant and pre-school group(0-6 years old),and100(31.7%)were in the school-age group(6 years old).There was a significant difference in the composition of etiology among the age groups(χ 2 = 15.94,P = 0.014 < 0.05).Among them,UACS,CVA and UACS associated with CVA are the top three causes of chronic cough in children of all ages.The first cause of infant、preschool and school-age group was upper airway cough syndrome.(2)Relationship with gender: Among 315 children with chronic cough,172(54.6%)were male,143(45.4%)were female.There was no significant difference between the two groups(P = 0.71 > 0.05)(3)Relationship with the season: The study found that the incidence of chronic cough in children in Tianjin was higher in winter,and UACS,CVA and UACS combined with CVA were the main causes.There was no significant difference in the distribution of etiology among children in different seasons(P = 0.22 > 0.05)(4)The relationship with the course of disease: 213 cases(67.6%)in4-12 weeks,57 cases(18.1%)in 12-24 weeks,45 cases(14.3%)in > 24 weeks,of which the proportion of 4-weeks is the highest.The distributionof etiology in different course groups was statistically significant(χ 2 =39.2,P < 0.05)(5)The relationship with the regional distribution of Tianjin: Tianjin is divided into Binhai new area,central city,urban suburbs and agriculture areas.The incidence of chronic cough in central city was higher than other districts,and UACS was the highest incidence.There was no significant difference in the distribution of etiological factors in different regions(P=0.71>0.05).(6)Correlation with BMI: Among the 315 pediatric patients,there was statistically significant difference between etiologies and BMI.(P =0.008<0.05).(7)Others: Others:in this study,Rhinitis was present in 81.5%(66cases)of patients with CVA,48(59.3%)patients developed asthma in the CVA.Among the patients with UACS,101(77.1%)had rhinitis,12(9.2%)had sinusitis,and 18(13.7%)had rhinitis with adenoid hypertrophy.Conclusion:(1)Among 315 children with chronic cough in Tianjin,the top three were UACS,CVA,UACS combined with CVA,which were different from the results of national composition ratio,mainly due to the difference of Tianjin’s geographical location and the characteristics of environmental pollutants.(2)The nature of cough,course of disease,age of onset and BMI were all influential factors of chronic cough in children.The incidence of chronic cough in children in the central urban area of tianjin was higher than other districts,and the incidence of chronic cough in males was higher than females,and the incidence rate was higher in winter.However,the incidence rate of UACS was the highest in all of them,and there was no statistically significant difference in the proportion of causes and components between different regions,seasons and genders. |
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