儿童慢性咳嗽三种常见病因分布及肺功能变化的研究

发布时间：2018-07-03 00:48

本文选题：儿童 + 慢性咳嗽　；参考：《大连医科大学》2012年硕士论文

【摘要】：目的了解慢性咳嗽患儿三种常见病因分布、观察不同病因的肺功能改变，探讨儿童慢性咳嗽三种常见病因不同年龄组病因分布的状况、肺通气功能受累及气道可逆性阻塞的特点，为儿童慢性咳嗽三种常见病因的诊断及鉴别诊断提供一定的依据。方法采用前瞻性、连续采样的方法，选择符合儿童慢性咳嗽纳入标准的2009年3月至2012年2月在大连市儿童医院慢性咳嗽门诊就诊的患儿，年龄在3-12岁，除外急性咳嗽、特异性咳嗽、有基础疾病的慢性咳嗽以及根据我院目前诊治条件尚不能给予明确诊断的患儿，根据不同病因的临床特点和诊断线索，按照慢性咳嗽的诊断流程，予以辅助检查、诊断性治疗及定期随访，进行诊断或修正诊断，对明确诊断的CVA、RI and PIC和UACS的三组患儿，按不同年龄组分析三种常见病因的分布，用力依赖性肺通气功能、支气管舒张试验的变化及比较。结果 1.慢性咳嗽患儿三种常见病因分别为CVA、RI and PIC、UACS；100例中有105例次病因诊断明确，，单一病因95例，占95%，二重病因5例，占5%。 2.儿童慢性咳嗽患者病因分布 2.1105例次的慢性咳嗽患儿三种常见病因CVA、RI and PIC、UACS构成比依次为44%、29%、27%，以CVA组最高。 2.2不同年龄组三种常见病因的构成比不同，CVA在慢性咳嗽学龄前组与学龄组所占百分比均位于首位，RI and PIC在学龄前组高于UACS，而UACS则在学龄组居多。 3.用力依赖性肺通气功能的改变 3.1三种常见病因肺通气功能障碍阳性患儿的病因构成 105例次慢性咳嗽患儿肺通气功能大致正常者52例次，占49%，通气功能障碍者53例次，占51%；通气功能障碍的慢性咳嗽患儿三种常见病因CVA、RI andPIC、UACS构成比依次为55%、24%、21%，以CVA患儿居多。 3.2三种常见病因肺通气功能障碍阳性率的比较 105例次慢性咳嗽患儿中CVA组、RI and PIC组、UACS组肺通气功能障碍阳性率依次为63.0%、43.3%和37.9%，以CVA组阳性率最高；经卡方检验，χ2=19.9，P＜0.001，提示三种常见病因肺通气功能障碍阳性率存在差异，有统计学意义。 3.3支气管舒张试验阳性患儿的病因构成 78例次慢性咳嗽患儿支气管舒张试验阴性结果有64例次，占69.24%，阳性结果有24例次，占30.76%；支气管舒张试验阳性患儿的三种常见病因CVA、RI andPIC、UACS构成比依次为55%、24%、21%，以CVA最高。 3.4三种常见病因支气管舒张试验阳性率的比较 78例次慢性咳嗽患儿进行支气管舒张试验，CVA、RI and PIC、UACS气管舒张试验阳性率依次为53%、18%、12.5%，以CVA阳性率最高；经卡方检验，χ2=22.3，P＜0.001，提示三种常见病因支气管舒张试验阳性率存在差异，有统计学意义。结论 1.3-12岁儿童慢性咳嗽的三种常见病因的构成依次为CVA、RI and PIC、UACS。 2.儿童慢性咳嗽病因构成以CVA为主；除CVA学龄前组患儿以RI and PIC居多，而学龄组以UACS居多。 3.儿童慢性咳嗽三种常见病因肺通气功能障碍的阳性率不同，CVA、RI andPIC、UACS依次为63.0%、43.3%、37.9%，以CVA最高。 4.儿童慢性咳嗽三种常见病因支气管舒张试验阳性率不同，CVA、RI and PIC、UACS依次为：53%、18%、12.5%；CVA的阳性率最高，而RI and PIC、UACS的阳性率低，而阴性率较高。
[Abstract]:Objective to understand the three common causes of chronic cough in children, observe the changes in the pulmonary function of different causes, explore the distribution of the causes of the three common causes of chronic cough in children, the pulmonary ventilation function and the reversible airway obstruction, and provide the diagnosis and differential diagnosis of three common causes of chronic cough in children. The basis of the decision.
Methods a prospective, continuous sampling method was used to select children with chronic cough in Dalian children's Hospital from March 2009 to February 2012. The age was 3-12 years old, with the exception of acute coughing, specific cough, chronic cough with basic diseases, and the condition of current diagnosis and treatment in our hospital. According to the clinical characteristics and diagnostic clues of different pathogeny, according to the clinical characteristics and diagnostic clues of different causes, the diagnosis of chronic cough, diagnostic treatment and regular follow-up, diagnosis or correction, three groups of patients with clear diagnosis of CVA, RI and PIC and UACS, were used to analyze the distribution of the three common causes by different age groups. Changes and comparisons of lung function and bronchodilation test.
Result
1. the three common causes of children with chronic cough were CVA, RI and PIC, UACS, and 105 of the 100 cases were diagnosed, 95, 95%, and 5, accounting for 5%..
Etiological Distribution of 2. children with chronic cough
2.1105 cases of chronic cough children three common causes CVA, RI and PIC, UACS constituent ratio was 44%, 29%, 27%, the highest in CVA group.
2.2 the proportion of the three common causes in different age groups was different. The percentage of CVA in the preschool group and the school age group in the chronic cough was the first, and the RI and PIC was higher than the UACS in the preschool age group, while the UACS in the school age group was most.
The changes of 3. forced dependent pulmonary ventilation
3.1 etiology of three common causes of positive pulmonary ventilation dysfunction
The lung ventilation function of 105 children with chronic cough was 52 times, 49% and 51% for ventilatory dysfunction. Three common causes of chronic cough in children with ventilation dysfunction CVA, RI andPIC, and UACS constituent ratio were 55%, 24%, 21%, with the majority of children with CVA.
3.2 comparison of positive rates of three common causes of pulmonary ventilation dysfunction
In the group CVA and the RI and PIC group, the positive rate of pulmonary ventilation dysfunction in group UACS was 63%, 43.3% and 37.9% in group UACS, and the positive rate in group CVA was the highest. The positive rate of three common causes of lung ventilation dysfunction was statistically significant by chi square test, chi square and P < 0.001.
Etiology of 3.3 children with positive bronchial dilation test
The negative results of bronchial diastolic test in 78 children with chronic cough were 64 cases, accounting for 69.24%, and the positive results were 24 times, accounting for 30.76%. The three common causes of children with positive bronchial diastolic test were CVA, RI andPIC, and the UACS constituent ratio was 55%, 24%, 21%, with the highest CVA.
3.4 comparison of positive rates of three common causes of bronchodilation test
78 cases of children with chronic cough were tested for bronchodilation, CVA, RI and PIC, and the positive rate of UACS tracheal diastolic test was 53%, 18%, 12.5%, and the positive rate of CVA was the highest. By chi square test, chi square, P < 0.001, suggesting that the positive rates of bronchial diastolic test were different in three common causes, with statistical significance.
conclusion
The three common causes of chronic cough in children aged 1.3-12 were CVA, RI and PIC and UACS..
2. the etiology of chronic cough in children was mainly CVA, while in CVA preschool group, RI and PIC was the majority, while school-age group was mostly UACS.
3. there were three common causes of chronic cough in children. The positive rates of pulmonary ventilation dysfunction were different. CVA, RI andPIC and UACS were 63%, 43.3%, 37.9%, respectively, and the highest was CVA.
4. the positive rates of bronchial diastolic test in three common causes of chronic cough in children were different, CVA, RI and PIC, UACS were 53%, 18%, 12.5%, and the positive rate of CVA was the highest, while RI and PIC, UACS positive rate was low, but negative rate was higher.
【学位授予单位】：大连医科大学
【学位级别】：硕士
【学位授予年份】：2012
【分类号】：R725.6

【参考文献】