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分析婴幼儿重症百日咳的临床特征:一项回顾性研究。

Analysis of clinical characteristics of severe pertussis in infants and children: a retrospective study.

机构信息

Department of Pediatrics, Beijing Ditan Hospital, Capital Medical University, Beijing, China.

出版信息

BMC Pediatr. 2021 Feb 5;21(1):65. doi: 10.1186/s12887-021-02507-4.

Abstract

The incidence of pertussis shows an increasing trend in recent years, but some clinicians often lack sufficient understanding of the clinical characteristics and risk factors for severe pertussis, and more effective measures should be taken to reduce the incidence and mortality of pertussis in young infants METHODS: A retrospective study was conducted, and 184 infants and children with pertussis who had been hospitalized in the Department of Pediatrics of Beijing Ditan Hospital affiliated with Capital Medical University from January 2016 to December 2017 were included. Clinical data of the patients were collected and the clinical characteristics were statistically analyzed RESULTS: Among the 184 patients, 41.85% were infants < 3 months of age, and 65.22% of the total patients were not vaccinated against pertussis. There were 22 critically ill children, among whom 4 died, and compared with mild cases, they had a higher proportion of children younger than 3 months of age and infants not vaccinated against pertussis (63.64% vs. 38.89% and 100% vs. 60.49%, respectively); a higher proportion of children with severe pneumonia (100% vs. 0%); higher leukocyte count(× 109/L , 35.80 ± 20.53 vs 19.41 ± 8.59); and a higher proportion of children with severe hyperleukocytosis (18.18% vs. 0%, respectively) (P<0.05) CONCLUSIONS: 1. Infants aged <3 months not vaccinated for pertussis appear more likely to become infected and have more severe disease. 2. Severe pneumonia and hyperleukocytosis are the main mechanisms underlying severe pertussis.

摘要

近年来,百日咳的发病率呈上升趋势,但部分临床医生对重症百日咳的临床特征和危险因素认识不足,应采取更有效的措施降低婴幼儿百日咳的发病率和死亡率。

方法

回顾性分析 2016 年 1 月至 2017 年 12 月首都医科大学附属北京地坛医院儿科收治的 184 例住院百日咳患儿的临床资料,统计分析其临床特征。

结果

184 例患儿中,年龄<3 个月者占 41.85%,未接种百白破疫苗者占 65.22%。22 例重症患儿中,死亡 4 例,与轻症患儿相比,年龄<3 个月及未接种百白破疫苗者所占比例较高(63.64%比 38.89%、100%比 60.49%),重症肺炎所占比例较高(100%比 0%),白细胞计数较高[(35.80±20.53)×109/L 比(19.41±8.59)×109/L],重度高白细胞血症发生率较高(18.18%比 0%),差异均有统计学意义(P<0.05)。

结论

1.未接种百白破疫苗的<3 个月龄婴儿更易感染且病情较重。2.重症肺炎和重度高白细胞血症是导致重症百日咳的主要机制。

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