【摘要】 目的分析北京地区单中心住院儿童百日咳的临床特征。方法对2015年1月～2018年12月在笔者医院住院经聚合酶链反应(PCR)方法检测确诊百日咳患儿的临床资料进行回顾性研究。结果 56例患儿中男性31例(55.4%),女性25例(44.6%)。发病年龄为10天～10岁,中位数75天。未接种疫苗41例(73.2%),有明确接触史29例(51.8%)。发病季节:春季14例,夏季19例,秋季11例,冬季12例。入院时咳嗽持续时间2～40天,平均14.36±8.70天。痉挛性咳嗽54例(96.4%),发绀30例(53.6%),喘息25例(44.6%),发热、呼吸困难各18例(32.1%),吸气末回钩10例(17.9%),呼吸暂停9例(16.1%)。肺部中小水泡音及喘鸣音各20例(35.7%)。并发百日咳肺炎46例(82.1%)。血常规白细胞计数增高54例(96.4%),中位数为19.66×10~9/L,淋巴细胞比例平均值66.48%±9.79%。CRP升高6例(10.7%)。重症患者23例(41.1%),重症组喘息的发生率高于与普通组(P<0.05),且CRP升高的发生率高于普通组(P<0.05)。住院时间1～70天,中位数为6天。除死亡1例(1.8%)之外均好转出院。结论儿童百日咳好发于未接种疫苗的婴儿,约半数有明确接触史,全年散发。百日咳肺炎常见,喘息、CRP升高可能提示为重症病例。更多还原

【Abstract】 Objective To analyze the clinical characteristics of pertussis cases in hospitalized children in a single center of Beijing region. Methods Patients diagnosed as pertussis admitted in Affiliated Children′s Hospital of Capital Institute of Pediatrics from January 2015 to December 2018 were included in this study. They had been diagnosed with Bordetella pertussis infection by polymerase chain reaction(PCR). A retrospectively observational study of the clinical data was conducted. Results Altogether there were 56 sputum samples tested positive for B. pertussis. There were 31 males and 25 females. The age of onset was from 10 days to 10 years, and the median was 75 d. 41 cases(73.2%)were unvaccinated, 29 cases(51.8%)were exposed. 14 cases were found in spring, 19 in summer, 11 in fall, and 12 in winter. The duration of cough by the time of admission was 2-40 d, mean 14.36±8.70 d. The clinical symptoms were paroxysmal cough(96%), cyanosis(53.6%), wheeze(44.6%), fever、dyspnea(32.1%), inspiratory whoop(17.9%) and apnea(16.1%). Moist rales and wheeze were heard in the lung fields in 20 cases(35.7%)respectively. 46 cases(82.1%) complicated with pneumonia. The white blood cell count increased in 54 cases(96%), with a median of 19.66×10~9/L and the average proportion of lymphocytes was 66.48%±9.79%. The serum levels of C-reactive protein(CRP) were elevated in 6 cases(10.7%). 23(41.1%) patients were severe cases. The incidence of wheeze in the severe group was higher than that in the common group(P<0.05).The incidence of elevated CRP in severe group was higher than that in common group(P<0.05). The length of hospital stay was 1-70 d, and the median stay was 6 d. 55 patients′ condition improved and they were discharged, but one infant(1.8%)died.Conclusion Unvaccinated infants are more likely to be infected by pertussis in childhood. About half cases have a history of exposure. The disease may occur throughout the year. Pertussis pneumonia is common. Wheeze and elevated CRP levels may indicate severe pertussis.更多还原