吉林省儿童慢性咳嗽病因构成比分析
|
摘要
本文旨在观察吉林省儿童慢性咳嗽的病因构成及分析不同年龄组儿童慢性咳嗽的常见病因。选取83例于我科明确诊断为慢性咳嗽的患儿(均来自吉林省)。所有患儿均满足以下条件:年龄≤14岁,肺部无阳性体征,咳嗽时间大于4周,胸片无异常。采用《儿童慢性咳嗽诊断与治疗指南(试行)》并结合患儿的实际情况进行初步病因诊断,提供治疗方案。分别在完成治疗后半个月、1个月及3个月进行门诊或电话随访,根据治疗反应确定慢性咳嗽的病因。若治疗无效时选择相关辅助检查进一步明确病因。83例患儿中有80例完成随访,其中79例(79/80,98.8%)病因明确,1例(1/80,1.3%)病因未明。病因明确者中单一病因76例(76/79,96.2%),二重病因3例(3/79,3.8%)。包括二重病因在内,共计83例次慢性咳嗽病因。前4位病因依次为咳嗽变异性哮喘,呼吸道感染及感染后咳嗽,上气道咳嗽综合征及过敏性咳嗽。在婴幼儿组,呼吸道感染及感染后咳嗽居慢性咳嗽病因的首位;在学龄前和学龄期儿童组,咳嗽变异性哮喘居病因首位。因此吉林省儿童慢性咳嗽是由多病因引起的,其中主要有咳嗽变异性哮喘,呼吸道感染及感染后咳嗽,上气道咳嗽综合征及过敏性咳嗽,且不同年龄阶段病因分布有一定特征性。
Background: Cough is an important defense mechanism that helps clear the respiratory secretions and harmful factors from the airways, whether in adults or children, are the most common respiratory out-patient clinical symptoms. And to cough as the sole or main symptoms of chronic cough and continued refractory often doctors lack of knowledge of treatment difficult.
The past 20 years, many European and American countries and the domestic are the causes of adult cough and its treatment in various aspects of the system and to develop guidelines on diagnosis and treatment of cough. However, research in the field of children with chronic cough, the domestic late start, much less documented. Because children are not miniature adults, and its anatomical, physiological and immunological aspects are some differences between adults, so apply theory and experience in adults with chronic cough to analysis and diagnosis of the cause of chronic cough in children, and sometimes can not get the expected results and child growth and development of different ages there own characteristics.Therefore, all age groups are common causes of chronic cough there are differences.
Chronic cough is defined as the only or main symptom of patients, X-ray examination of chest showed normal but cough of unknown reasons, the domestic current diagnosis of chronic cough in children, the duration of cough was considered more than 4 weeks. The etiology of chronic cough is variable,and more than one pathogenic factor occurs in one patient. However, children with chronic cough on the lack of domestic multi-center, large sample, prospective study of epidemiological survey data.This study is one of the single center in "Chinese children with chronic cough in multi-center study constitutes" ,which is on going.
Objective:To detect and classify the pathogenic factors of chronic cough in children in Jilin province; Observation and analysis of different age groups of children are common causes of chronic cough.
Methods: A total of 83 patients referred to in this dissertation were those who went to the pediatric respiratory medicine clinic of the First Hospital of Jilin University, for their coughs from May 2009 to January 2010, of which were all from Jilin Province territory. All children aged≤14 years, no signs of the lungs, cough time was more than four weeks, the chest radiograph was normal. Use of "Diagnosis and treatment of children with chronic cough Guide (trial)" made the diagnosis process, and make the appropriate adjustments, concrete steps are as follows:①detailed history, including cough nature, when the phase, duration, related factors, accompanying symptoms, the initial onset cases (with or without foreign body aspiration, cough history, etc.), past medical history (especially rhinitis, asthma history, immune status), growth and development history, family history, allergies, history of exposure to infectious diseases (especially whooping cough and TB), the recent examination and treatment and so on.②line comprehensive physical examination, not only for the respiratory system.Taking care of other systems, if necessary, the related specialist visits.③According to the medical history, physical examination, conventional X-ray, blood routine, serum IgM antibody against Mycoplasma pneumoniae; other examinations will be selected, including pulmonary function, allergy testing, PPD skin test, lung CT, Electronics nasopharyngeal endoscopy, esophageal barium meal, etc., necessary for fiberoptic bronchoscopy examination or diagnostic treatment.④According to the information available to make a preliminary diagnosis of the cause and provide treatment.⑤After completion of treatment were two weeks, 1 month and 3 months, 3 times out / telephone follow-up, and ultimately determine the treatment response according to the cause of chronic cough, ineffective treatment and then select the additional tests.The disease specific diagnostic criteria and treatment options related to the literature and see the combination of line-related adjustment in children with specific conditions.
Results: 83 patients were followed up during the case off in 3 cases. Children with complete follow-up of 80 cases diagnosed in 79 cases (98.8%), unknown etiology in 1 case (1.2%). Confirmed by the single cause of 76 cases (96.2%), duplex causes in 3 cases (3.8%). Including duplex causes included, a total of 83 cases of chronic cough. The four important causes were cough variant asthma (45.8%), respiratory infections and postinfectious cough (41.0%), upper airway cough syndrome (6%), atopic cough (of 2.4%). In infants and toddlers group, respiratory infections and postinfectious cough did cough of chronic data for the first; in preschool and school-age children, the first cause of chronic cough is cough variant asthma. The three cases of chronic disease in duplex cases, two of the children were both have the Upper airway cough syndrome and cough variant asthma, one has the Upper airway cough syndrome and bronchiectasis. Three months after the visit, the patient cough all last a long time, provided treatment, two of the cases the cough symptoms of clinical control, one of the cough of the previous alleviate the symptoms. There is a chronic cough was not clear the diagnosis .
Conclusion:
1. Children with chronic cough complex, Jilin Province, the region is mainly the cause of chronic cough cough variant asthma, respiratory infections and postinfectious cough, upper airway cough syndrome, and allergic cough;
2. A "diagnosis of children with chronic cough and treatment guidelines (Trial) "proposed diagnostic procedure to diagnose the vast majority of chronic cough in children; Treatment for the cause of the child will relieve the symptoms.
3. Children with chronic cough etiology in different age groups have a certain characteristic distribution: In infants and toddlers group, respiratory infections and postinfectious cough did cough of chronic data for the first; in preschool and school-age children, the first cause of chronic cough is cough variant asthma.
Background: Cough is an important defense mechanism that helps clear the respiratory secretions and harmful factors from the airways, whether in adults or children, are the most common respiratory out-patient clinical symptoms. And to cough as the sole or main symptoms of chronic cough and continued refractory often doctors lack of knowledge of treatment difficult.
The past 20 years, many European and American countries and the domestic are the causes of adult cough and its treatment in various aspects of the system and to develop guidelines on diagnosis and treatment of cough. However, research in the field of children with chronic cough, the domestic late start, much less documented. Because children are not miniature adults, and its anatomical, physiological and immunological aspects are some differences between adults, so apply theory and experience in adults with chronic cough to analysis and diagnosis of the cause of chronic cough in children, and sometimes can not get the expected results and child growth and development of different ages there own characteristics.Therefore, all age groups are common causes of chronic cough there are differences.
Chronic cough is defined as the only or main symptom of patients, X-ray examination of chest showed normal but cough of unknown reasons, the domestic current diagnosis of chronic cough in children, the duration of cough was considered more than 4 weeks. The etiology of chronic cough is variable,and more than one pathogenic factor occurs in one patient. However, children with chronic cough on the lack of domestic multi-center, large sample, prospective study of epidemiological survey data.This study is one of the single center in "Chinese children with chronic cough in multi-center study constitutes" ,which is on going.
Objective:To detect and classify the pathogenic factors of chronic cough in children in Jilin province; Observation and analysis of different age groups of children are common causes of chronic cough.
Methods: A total of 83 patients referred to in this dissertation were those who went to the pediatric respiratory medicine clinic of the First Hospital of Jilin University, for their coughs from May 2009 to January 2010, of which were all from Jilin Province territory. All children aged≤14 years, no signs of the lungs, cough time was more than four weeks, the chest radiograph was normal. Use of "Diagnosis and treatment of children with chronic cough Guide (trial)" made the diagnosis process, and make the appropriate adjustments, concrete steps are as follows:①detailed history, including cough nature, when the phase, duration, related factors, accompanying symptoms, the initial onset cases (with or without foreign body aspiration, cough history, etc.), past medical history (especially rhinitis, asthma history, immune status), growth and development history, family history, allergies, history of exposure to infectious diseases (especially whooping cough and TB), the recent examination and treatment and so on.②line comprehensive physical examination, not only for the respiratory system.Taking care of other systems, if necessary, the related specialist visits.③According to the medical history, physical examination, conventional X-ray, blood routine, serum IgM antibody against Mycoplasma pneumoniae; other examinations will be selected, including pulmonary function, allergy testing, PPD skin test, lung CT, Electronics nasopharyngeal endoscopy, esophageal barium meal, etc., necessary for fiberoptic bronchoscopy examination or diagnostic treatment.④According to the information available to make a preliminary diagnosis of the cause and provide treatment.⑤After completion of treatment were two weeks, 1 month and 3 months, 3 times out / telephone follow-up, and ultimately determine the treatment response according to the cause of chronic cough, ineffective treatment and then select the additional tests.The disease specific diagnostic criteria and treatment options related to the literature and see the combination of line-related adjustment in children with specific conditions.
Results: 83 patients were followed up during the case off in 3 cases. Children with complete follow-up of 80 cases diagnosed in 79 cases (98.8%), unknown etiology in 1 case (1.2%). Confirmed by the single cause of 76 cases (96.2%), duplex causes in 3 cases (3.8%). Including duplex causes included, a total of 83 cases of chronic cough. The four important causes were cough variant asthma (45.8%), respiratory infections and postinfectious cough (41.0%), upper airway cough syndrome (6%), atopic cough (of 2.4%). In infants and toddlers group, respiratory infections and postinfectious cough did cough of chronic data for the first; in preschool and school-age children, the first cause of chronic cough is cough variant asthma. The three cases of chronic disease in duplex cases, two of the children were both have the Upper airway cough syndrome and cough variant asthma, one has the Upper airway cough syndrome and bronchiectasis. Three months after the visit, the patient cough all last a long time, provided treatment, two of the cases the cough symptoms of clinical control, one of the cough of the previous alleviate the symptoms. There is a chronic cough was not clear the diagnosis .
Conclusion:
1. Children with chronic cough complex, Jilin Province, the region is mainly the cause of chronic cough cough variant asthma, respiratory infections and postinfectious cough, upper airway cough syndrome, and allergic cough;
2. A "diagnosis of children with chronic cough and treatment guidelines (Trial) "proposed diagnostic procedure to diagnose the vast majority of chronic cough in children; Treatment for the cause of the child will relieve the symptoms.
3. Children with chronic cough etiology in different age groups have a certain characteristic distribution: In infants and toddlers group, respiratory infections and postinfectious cough did cough of chronic data for the first; in preschool and school-age children, the first cause of chronic cough is cough variant asthma.
引文
[1] Morice AH, Fontana GA, Sovijarvi AR, et al. The diagnosis and management of chronic cough [J]. Eur Respir J, 2004, 24(3):481-492.
[2] Chang AB, Glomb WB. Guidelines for evaluating chronic cough in pediatrics: ACCP evidence-based clinical practice guidelines [J]. Chest, 2006, 129(1 Suppl):260S-283S.
[3] Munyard P, Bush A..How much coughing is normal? [J]. Arch Dis Child, 1996, 74(6):531-534.
[4] Mcgarvey L, Morice AH. Atopic cough:little evidence to support a new clinical entity [J]. Thorax, 2003, 58(8):736-737.
[5]中华医学会儿科学分会呼吸学组,《中华儿科杂志》编辑委员会.儿童慢性咳嗽诊治指南(试行) [J].中华儿科杂志, 2008,46(2): 104-107.
[6] Irwin RS, Madison JM. Anatomical diagnostic protocol in evaluating chronic cough with specific reference to gastroesophageal reflux disease [J]. Am J Med, 2000, 108(Suppl 4a):126S-130S.
[7] Palombini BC, Villanova CA, Araujo E, et al. A pathogenic triad in chronic cough: asthma, postnasal drip syndrome, and gastroesophageal reflux disease [J]. Chest, 1999, 116(2):279-284.
[8]赖克方,陈如冲,钟南山等.不明原因慢性咳嗽的病因分布及诊断程序的建立[J];中华结核和呼吸杂志, 2006,29(2):96-99.
[9]张海邻,李昌崇.儿童慢性咳嗽诊断中几个值得关注的问题[J].实用儿科临床杂志, 2008,23(16):1228-1230.
[10]Velissariou IM, Kafetzis DA. Chronic cough in children: recent advances [J]. Expert Rev Anti Infect Ther, 2004, 2(1):111-117.
[11]Pratter MR, Abouzgheib W. Make the cough go away [J]. Chest, 2006, 129(5):1121-1122.
[12]Hay AD, Wilson AD. The natural history of acute cough in children aged 0 to 4 years in primary care: a systematic review[J]. Br J Gen Pract, 2002, 52(478):401-409.
[13]赵顺英,任亦欣,江载芳.慢性孤立性咳嗽患儿50例病因和诊断程序[J].中国实用儿科杂志, 2006,21(2):109-111.
[14]Brightling CE, Ward R, Goh KL, et al. Eosinophilic bronchitis is an important cause of chronic cough[J]. Am J Respir Crit Care Med, 1999, 160(2):406-410.
[15]IrwinRS, Boulet LP, Cloutier MM, et al. Managing cough as a defense mechanism and as a symptom. A consensus panel report of the American College of Chest Physicians[J]. Chest, 1998, 114(2 Suppl Managing): 133S-181S.
[16] Irwin RS, Corrao WM, Pratter MR. Chronic persistent cough in the adu1t: the spectrum and frequency of causes and successful outcome of specific therapy [J]·Am Rev Respir Dis, 1981, 123(4 Pt1):413-417.
[17]Irwin RS, Curley FJ, French CL.Chronic cough.The spectrum and frequency of causes, key components of the diagnostic evaluation, and outcome of specific therapy [J]·Am Rev Respir Dis, 1990, 141(3): 640-647.
[18] McCrory DC, Lewis SZ. Methodology and grading of the evidence for the diagnosis and management of cough: ACCP evidence-based clinical practice guidelines [J]. Chest, 2006, 129(1 Suppl): 28S-32S.
[19]Marchant JM, Masters IB, Taylor SM, et al. Evaluation and outcome of young children with chronic cough [J]. Chest, 2006, 129(5): 1132-1141.
[20]张海邻,潘益匆.国内小儿慢性咳嗽的文献回顾研究[C].儿童慢性咳嗽与反复呼吸道感染学术研讨会资料汇编, 2007:63-67.
[21]Fitch PS, Brown V, Schock BC, et a1. Chronic cough in children: bronchoalveolar lavage findings [J]. Eur Respir J, 2000, l6(6):l109-1114.
[22] Chang AB, Landau LI, Van Asperen PP, et al. Cough in children: definitionsand clinical evaluation [J]. Med J Aust, 2006, 184(8): 398-403.
[23]何奎华.小儿慢性咳嗽与肺炎支原体的关系[J].中国当代儿科杂志, 2002, 4(6):529.
[24]Havlir DV, Barnes PF. Tuberculosis in patients with human immuno- -deficiency virus infection [J]. N Engl J Med, 1999, 340(5): 367-373.
[25] Pratter MR. Chronic upper airway cough syndrome secondary to rhinosinus diseases (previously referred to as postnasal drip syndrome): ACCP evidence-based clinical practice guidelines [J]. Chest, 2006, 129 (1Suppl):63S-71S.
[26]Tatli MM, San I, Karaoglanoglu M. Paranasal sinus computed tomographic findings of children with chronic cough [J]. Int J Pediatr Otorhinolaryngol, 2001, 60(3):213-217.
[27]Glauser FL. Variant asthma [J]. Ann Allergy, 1972, 30(8):457-459.
[28]Hannaway PJ, Hopper GD. Cough variant asthma in children [J]. JAMA, 1982, 247(2):206-208.
[29]Nakajima T, Nishimura Y, Nishiuma T, et al. Cough sensitivity in pure cough variant asthma elicited using continuous capsaicin inhalation [J]. Allergol Int, 2006, 55(2): 149-155.
[30] Koh YY, Chae SA, Min KU. Cough variant asthma is associated with a higher wheezing threshold than classic asthma [J]. Clin Exp Allergy, 1993, 23(8):696-701.
[31]中华医学会儿科学分会呼吸学组(2008年修订).儿童支气管哮喘诊断与防治指南[J].中华儿科杂志, 2008, 46(10):745-753.
[32]Todokoro M, Mochizuki H, Tokuyama K, et al. Childhood cough variant asthma and its relationship to classic asthma [J]. Ann Allergy Asthma Immunol, 2003, 90(6):652-659.
[33] Fouad YM, Katz PO, Hatlebakk JG, et al. Ineffective esophageal motility: the most common motility abnormality in patients with GERD- associatedrespiratory symptoms [J]. Am J Gastroenterol, 1999, 94(6):1464-1467.
[34]刘峰,江米足,周雪莲,余金丹.小儿慢性咳嗽与胃食管反流的关系[J].临床儿科杂志, 2007, 25(6):442-444.
[35]Irwin RS.Chronic cough due to gastroesophageal reflux disease:ACCP evidence-based clinical practice guidelines[J]. Chest, 2006, 129(1Suppl): 80S-94S.
[36]赖克方.慢性咳嗽病因的诊断与治疗[C].中国中西医结合学会变态反应学术大会论文汇编, 2009:27-36.
[37]Gibson PG, Dolovich J, Denburg J, et al. Chronic cough: eosinophilic bronchitis without asthma[J]. Lancet, 1989, 1(8651):1346-1348.
[38]董传莉,潘家华.儿童慢性咳嗽的研究进展[J].实用全科医学, 2008, 6(4):409-410.
[39] Brightling CE, Ward R, Woltmann G, et al. Induced sputum inflammatory mediator concentrations in eosinophilic bronchitis and asthma. Am J Respir Crit Care Med, 2000, 162(3 Pt 1):878-882.
[40] Brightling CE, Bradding P, Symon FA, et al. Mast-cell infiltration of airway smooth muscle in asthma [J]. N Engl J Med, 2002, 346(22):1699-1705.
[41] Thomson F, Masters IB, Chang AB. Persistent cough in children and the overuse of medications [J]. Paediatr Child Health, 2002, 38(6):578-581.
[42] Fujimura M, Ogawa H, Nishizawa Y, et al. Comparison of atopic cough with cough variant asthma: is atopic cough a precursor of asthma? Thorax, 2003, 58:14-18.
[43]Tan H, Buyukavci M, Arik A. Tourette′s syndrome manifests as chronic persistent cough [J]. Yonsei Med J, 2004, 45(1):145-149.
[44]孔维佳,王斌全.耳鼻咽喉科学[M].第1版.北京:人民卫生出版社, 2002, 52-56 ,75-80.
[45] Chung KF. Chronic cough: future directions in chronic cough: mechanisms and antitussives [J]. Chron Respir Dis, 2007, 4(3):159-165.
[46]Kastelik JA, Aziz I, Ojoo JC, et al. Investigation and management of chronic cough using a probability-based algorithm. Eur Respir [J], 2005, 25(2): 235-243.
[47]Pratter MR. Overview of Common Causes of Chronic Cough: ACCP evidence-based clinical practice guidelines. Chest, 2006 , 129: 59 S-62S.
[2] Chang AB, Glomb WB. Guidelines for evaluating chronic cough in pediatrics: ACCP evidence-based clinical practice guidelines [J]. Chest, 2006, 129(1 Suppl):260S-283S.
[3] Munyard P, Bush A..How much coughing is normal? [J]. Arch Dis Child, 1996, 74(6):531-534.
[4] Mcgarvey L, Morice AH. Atopic cough:little evidence to support a new clinical entity [J]. Thorax, 2003, 58(8):736-737.
[5]中华医学会儿科学分会呼吸学组,《中华儿科杂志》编辑委员会.儿童慢性咳嗽诊治指南(试行) [J].中华儿科杂志, 2008,46(2): 104-107.
[6] Irwin RS, Madison JM. Anatomical diagnostic protocol in evaluating chronic cough with specific reference to gastroesophageal reflux disease [J]. Am J Med, 2000, 108(Suppl 4a):126S-130S.
[7] Palombini BC, Villanova CA, Araujo E, et al. A pathogenic triad in chronic cough: asthma, postnasal drip syndrome, and gastroesophageal reflux disease [J]. Chest, 1999, 116(2):279-284.
[8]赖克方,陈如冲,钟南山等.不明原因慢性咳嗽的病因分布及诊断程序的建立[J];中华结核和呼吸杂志, 2006,29(2):96-99.
[9]张海邻,李昌崇.儿童慢性咳嗽诊断中几个值得关注的问题[J].实用儿科临床杂志, 2008,23(16):1228-1230.
[10]Velissariou IM, Kafetzis DA. Chronic cough in children: recent advances [J]. Expert Rev Anti Infect Ther, 2004, 2(1):111-117.
[11]Pratter MR, Abouzgheib W. Make the cough go away [J]. Chest, 2006, 129(5):1121-1122.
[12]Hay AD, Wilson AD. The natural history of acute cough in children aged 0 to 4 years in primary care: a systematic review[J]. Br J Gen Pract, 2002, 52(478):401-409.
[13]赵顺英,任亦欣,江载芳.慢性孤立性咳嗽患儿50例病因和诊断程序[J].中国实用儿科杂志, 2006,21(2):109-111.
[14]Brightling CE, Ward R, Goh KL, et al. Eosinophilic bronchitis is an important cause of chronic cough[J]. Am J Respir Crit Care Med, 1999, 160(2):406-410.
[15]IrwinRS, Boulet LP, Cloutier MM, et al. Managing cough as a defense mechanism and as a symptom. A consensus panel report of the American College of Chest Physicians[J]. Chest, 1998, 114(2 Suppl Managing): 133S-181S.
[16] Irwin RS, Corrao WM, Pratter MR. Chronic persistent cough in the adu1t: the spectrum and frequency of causes and successful outcome of specific therapy [J]·Am Rev Respir Dis, 1981, 123(4 Pt1):413-417.
[17]Irwin RS, Curley FJ, French CL.Chronic cough.The spectrum and frequency of causes, key components of the diagnostic evaluation, and outcome of specific therapy [J]·Am Rev Respir Dis, 1990, 141(3): 640-647.
[18] McCrory DC, Lewis SZ. Methodology and grading of the evidence for the diagnosis and management of cough: ACCP evidence-based clinical practice guidelines [J]. Chest, 2006, 129(1 Suppl): 28S-32S.
[19]Marchant JM, Masters IB, Taylor SM, et al. Evaluation and outcome of young children with chronic cough [J]. Chest, 2006, 129(5): 1132-1141.
[20]张海邻,潘益匆.国内小儿慢性咳嗽的文献回顾研究[C].儿童慢性咳嗽与反复呼吸道感染学术研讨会资料汇编, 2007:63-67.
[21]Fitch PS, Brown V, Schock BC, et a1. Chronic cough in children: bronchoalveolar lavage findings [J]. Eur Respir J, 2000, l6(6):l109-1114.
[22] Chang AB, Landau LI, Van Asperen PP, et al. Cough in children: definitionsand clinical evaluation [J]. Med J Aust, 2006, 184(8): 398-403.
[23]何奎华.小儿慢性咳嗽与肺炎支原体的关系[J].中国当代儿科杂志, 2002, 4(6):529.
[24]Havlir DV, Barnes PF. Tuberculosis in patients with human immuno- -deficiency virus infection [J]. N Engl J Med, 1999, 340(5): 367-373.
[25] Pratter MR. Chronic upper airway cough syndrome secondary to rhinosinus diseases (previously referred to as postnasal drip syndrome): ACCP evidence-based clinical practice guidelines [J]. Chest, 2006, 129 (1Suppl):63S-71S.
[26]Tatli MM, San I, Karaoglanoglu M. Paranasal sinus computed tomographic findings of children with chronic cough [J]. Int J Pediatr Otorhinolaryngol, 2001, 60(3):213-217.
[27]Glauser FL. Variant asthma [J]. Ann Allergy, 1972, 30(8):457-459.
[28]Hannaway PJ, Hopper GD. Cough variant asthma in children [J]. JAMA, 1982, 247(2):206-208.
[29]Nakajima T, Nishimura Y, Nishiuma T, et al. Cough sensitivity in pure cough variant asthma elicited using continuous capsaicin inhalation [J]. Allergol Int, 2006, 55(2): 149-155.
[30] Koh YY, Chae SA, Min KU. Cough variant asthma is associated with a higher wheezing threshold than classic asthma [J]. Clin Exp Allergy, 1993, 23(8):696-701.
[31]中华医学会儿科学分会呼吸学组(2008年修订).儿童支气管哮喘诊断与防治指南[J].中华儿科杂志, 2008, 46(10):745-753.
[32]Todokoro M, Mochizuki H, Tokuyama K, et al. Childhood cough variant asthma and its relationship to classic asthma [J]. Ann Allergy Asthma Immunol, 2003, 90(6):652-659.
[33] Fouad YM, Katz PO, Hatlebakk JG, et al. Ineffective esophageal motility: the most common motility abnormality in patients with GERD- associatedrespiratory symptoms [J]. Am J Gastroenterol, 1999, 94(6):1464-1467.
[34]刘峰,江米足,周雪莲,余金丹.小儿慢性咳嗽与胃食管反流的关系[J].临床儿科杂志, 2007, 25(6):442-444.
[35]Irwin RS.Chronic cough due to gastroesophageal reflux disease:ACCP evidence-based clinical practice guidelines[J]. Chest, 2006, 129(1Suppl): 80S-94S.
[36]赖克方.慢性咳嗽病因的诊断与治疗[C].中国中西医结合学会变态反应学术大会论文汇编, 2009:27-36.
[37]Gibson PG, Dolovich J, Denburg J, et al. Chronic cough: eosinophilic bronchitis without asthma[J]. Lancet, 1989, 1(8651):1346-1348.
[38]董传莉,潘家华.儿童慢性咳嗽的研究进展[J].实用全科医学, 2008, 6(4):409-410.
[39] Brightling CE, Ward R, Woltmann G, et al. Induced sputum inflammatory mediator concentrations in eosinophilic bronchitis and asthma. Am J Respir Crit Care Med, 2000, 162(3 Pt 1):878-882.
[40] Brightling CE, Bradding P, Symon FA, et al. Mast-cell infiltration of airway smooth muscle in asthma [J]. N Engl J Med, 2002, 346(22):1699-1705.
[41] Thomson F, Masters IB, Chang AB. Persistent cough in children and the overuse of medications [J]. Paediatr Child Health, 2002, 38(6):578-581.
[42] Fujimura M, Ogawa H, Nishizawa Y, et al. Comparison of atopic cough with cough variant asthma: is atopic cough a precursor of asthma? Thorax, 2003, 58:14-18.
[43]Tan H, Buyukavci M, Arik A. Tourette′s syndrome manifests as chronic persistent cough [J]. Yonsei Med J, 2004, 45(1):145-149.
[44]孔维佳,王斌全.耳鼻咽喉科学[M].第1版.北京:人民卫生出版社, 2002, 52-56 ,75-80.
[45] Chung KF. Chronic cough: future directions in chronic cough: mechanisms and antitussives [J]. Chron Respir Dis, 2007, 4(3):159-165.
[46]Kastelik JA, Aziz I, Ojoo JC, et al. Investigation and management of chronic cough using a probability-based algorithm. Eur Respir [J], 2005, 25(2): 235-243.
[47]Pratter MR. Overview of Common Causes of Chronic Cough: ACCP evidence-based clinical practice guidelines. Chest, 2006 , 129: 59 S-62S.