儿童咳嗽的观察性研究：流行病学、对睡眠质量的影响和治疗转归
2012/02/29
背景：咳嗽是儿童最为常见的症状，也是导致儿童就诊的最常见症状。
方法：此项观察性试验旨在研究儿童急性咳嗽与上呼吸道感染（URTI）的相关性。对儿童咳嗽的流行病学及咳嗽对睡眠质量、儿童活动的影响、镇咳药物治疗的咳嗽临床转归进行研究。研究采用意大利咳嗽研究协会编制的儿童咳嗽问卷调查（PCQ）。433名因URTI导致急性咳嗽而就诊的儿童入选本研究，平均年龄为6.1岁（SD 3.6）。基础水平下，评价咳嗽类型、咳嗽持续时间、咳嗽严重程度和频率、咳嗽对儿童和父母睡眠的影响、咳嗽对上学和体育活动的影响。在接受镇咳药物（左羟丙哌嗪：n=101；中枢镇咳药：n=60）治疗和无治疗的（n=80）患儿中，基于治愈、改善、无变化和发作，评价治疗6天后咳嗽转归。进行描述性分析、卡方检验和采用逐步logistic回归分析进行的多变量分析。
结果：88%的患儿和72%的父母睡眠受到咳嗽的影响。镇咳药物治疗的患儿，基础水平下，左羟丙哌嗪治疗和中枢止咳药（氯哌斯汀和可待因）治疗患儿在咳嗽持续时间、咳嗽类型、咳嗽强度和咳嗽频率上无显著差异。左羟丙哌嗪和中枢止咳药能降低咳嗽强度和减少咳嗽频率。然而，左羟丙哌嗪治疗组咳嗽痊愈患儿的比例显著高于中枢止咳药治疗组（分别为47% vs. 28%，P=0.0012）。
结论：急性咳嗽能影响大部分患儿和父母的睡眠。左羟丙哌嗪和中枢止咳药能降低咳嗽强度，但左羟丙哌嗪治疗的咳嗽痊愈率更高。
（陈欣 审校）
Cough. 2012 Jan 23;8(1):1. [Epub ahead of print]
An observational study on cough in children: epidemiology, impact on quality of sleep and treatment outcome.
De Blasio F, Dicpinigaitis PV, Rubin BK, De Danieli G, Lanata L, Zanasi A.
Abstract
BACKGROUND: Cough is one of the most frequent symptoms in children and is the most common symptom for which children visit a health care provider.
METHODS: This is an observational study on acute cough associated with upper respiratory tract infection (URTI) in children. The study evaluates the epidemiology and impact of cough on quality of sleep and children’s activities, and the outcome of cough with antitussive treatments in pediatric routine clinical practice. Study assessments were performed through a pediatric cough questionnaire (PCQ), developed by the Italian Society of Cough Study. A total of 433 children visited by family care pediatricians for acute cough due to an URTI were enrolled in this study, with mean age of 6.1 years (SD 3.6). Cough type, duration, severity and frequency, cough impact on sleep disturbances of children and parents and on school and sport activities were assessed at baseline. In a subset of 241 children who were either treated with antitussive drugs (levodropropizine n=101, central antitussives n=60) or received no treatment (n=80), the outcome of cough after 6 days was analyzed in terms of resolution, improvement, no change, or worsening. Descriptive analysis, chi sq, and multivariate analysis with stepwise logistic regression were performed.
RESULTS: Cough disturbed sleep in 88% of children and 72% of parents. In children treated with cough suppressants, the duration, type, intensity, and frequency cough were similar at baseline in the two groups respectively treated with levodropropizine and central antitussives (cloperastine and codeine). Both levodropropizine and central drugs reduced cough intensity and frequency. However, percentage of cough resolution was higher with levodropropizine than with central antitussives (47% vs. 28% respectively, p=0.0012).
CONCLUSIONS: Acute cough disturbs sleep in most children and their parents. Both levodropropizine and central antitussives reduced cough intensity, with levodropropizine producing a higher cough resolution rate.
Cough. 2012 Jan 23;8(1):1. [Epub ahead of print]
