Clinical Characteristics Of Children With Chronic Cough Associated With Laryngopharyngeal Reflux

Objectives:Cough in children is associated with reflux,However,the diagnosis of reflux is often missed and misdiagnosed due to the lack of a"gold standard".In our hospital,24h Dx-p H monitoring has been developed,and the aim of this study was to characterize the clinical features of children with chronic cough associated with laryngopharyngeal reflux,and to provide a reference for the clinical diagnosis and treatment of children with chronic cough.Methods:Clinical data of 80 children with suspected diagnosis of laryngopharyngeal reflux(LPR)who visited the hospital due to chronic cough and were hospitalized in the respiratory department between January 2017 and January 2020 and underwent 24h Dx-p H monitoring were collected.Children in the LPR positive group were divided into LPR positive and negative groups based on the results of 24h Dx-p H monitoring to explore the clinical characteristics of chronic cough in children in the LPR positive group.Results:⑴Finally,among 80 children with chronic cough suspected of LPR,29 were found to be positive for 24h Dx-p H,The detection rate of LPR was 36.3%.⑵All 29children with LPR had acid reflux,including 19(65.5%)with orthostatic regurgitation,3(10.3%)with recumbent regurgitation,and 7(24.2%)with diplegic regurgitation.⑶Laryngopharyngeal reflux chronic cough,mainly dry cough,the positive group had a higher proportion of exercise-induced than the negative group(?~2=6.851,P=0.009);The positive group also had a higher proportion of history of eczema and recurrent respiratory infections than the negative group(?~2=4.579,P=0.032;?~2=4.457,P=0.044).⑷Among the chronic cough associated with throat reflux,13 patients(44.83%)had food allergy,4patients(13.79%)had inhalation allergy,and 7 patients(24.14%)had mixed allergy,of which the proportion of patients with food allergy in the positive group showed statistically significant difference compared with the negative group(?~2=11.160,P=0.01);The Fe NO value in the positive pharyngeal reflux group was 9.0(6.5-11.5)ppb,which was lower than that in the negative group(12.0(8.0-17.0)ppb(Z=﹣2.283,P=0.022).Conclusion:The incidence of LPR in children older than 2 years was higher in chronic cough that was refractory to conventional therapy,and the predominant reflux pattern was acid reflux in the standing position,independent of increasing age or gender;In terms of clinical features,dry cough predominates,is easily induced by exercise,and is highly prevalent in children with a previous history of eczema and recurrent respiratory infections;The predominant allergen type was food allergy,and the Fe NO values were not abnormally increased;Aggressive treatment of LPR may improve outcomes in children with chronic cough due to pharyngeal reflux.