摘要
目的 分析婴幼儿百日咳的发病特点及临床特征，提高对百日咳的认识，以便早期诊断和规范治疗。方法 采用回顾性分析方法对2011年至2013年在深圳市儿童医院住院的、经百日咳杆菌聚合酶链反应（PCR）检测证实为百日咳的142例患儿进行分析，数据采用SPSS16.0软件进行统计学处理。结果 142例患儿中，男96例，女46例，男女比例 2.11.0。其中年龄≤3个月93例，占总数的65.5% ；3～6个月26例，占总数的18.3% ；6～36个月23例，占总数的16.2% 。未接种或未全程接种的患儿约占总数的88.7% 。最常见的临床表现是阵发性咳嗽（73.2% ，104/142例），咳嗽终末伴有鸡鸣样、吸气性吼声6例（4.2%）。实验室检查外周血白细胞增高83例，以淋巴细胞增高为主，占90.4%（75/83例）。影像学诊断为肺炎86例（60.6%）。81例合并细菌、呼吸道病毒或肺炎支原体感染。3组患儿临床特征比较，在发热症状和呼吸道病原感染方面差异有统计学意义。≤3月龄患儿发热症状发生率低于其他2组患儿（χ2=11.45，P 〈0.01；χ2=34.56，P 〈0.01）；6～36月龄患儿合并其他病原感染发生率高于其他2组患儿（χ2=7.590，P 〈0.01；χ2=6.928，P 〈0.01）。结论 百日咳并不少见，特别是在小月龄、未接种疫苗或未全程接种疫苗的婴幼儿中；婴幼儿百日咳的临床表现和体征往往不典型，易误诊为肺炎等其他呼吸道感染。PCR检测百日咳DNA有助于婴幼儿百日咳的早期诊断。
Objective To explore the clinical manifestations and epidemiological profiles of hospitalized in- fants with Bordetella pertussis infection and to improve the knowledge for its early diagnosis and treatment. Methods Using a retrospective analysis method, the data of 142 hospitalized infants with Bordetella pertussis infection in Shen- zhen Children＇s Hospital from 2011 to 2013 were collected,which was confirmed by a real-time polymerase chain reac- tion（PCR） of nasopharyngeal secretion. The SPSS 16.0 software was used for statistical analysis. Results Of the 142 hospitalized infants with Bordetella pertussis infection,the ratio of male to female was 2.1 ： 1.0（96/41 cases）. Ninety- three （65.5%） cases were aged less than 3 months old,26 cases （18.3%） were 3 -6 months old and 23 cases （16.2%） were 6 -36 months old. One hundred and twenty-six （88.7%） patients were unvaccinated or incompletely vaccinated. The most common clinical manifestation was paroxysmal cough which accounts for 104/142 （73.2%） cases, and 6 cases of which had roaring （4.2%）. Peripheral blood WBC level of 83 cases increased, and 75 （90.4%） cases were lymphocytosis. The positive rate of X-ray was 60.6%. Eighty-one cases were complicated with bacteria, respiratory virus or mycoplasma pneumonia infection. There were significant differences in symptom of fever and infection of respiratory tract pathogen among 3 groups. The symptom of fever in the group aged less than 3 months old group was significantly lower than the other 2 groups （χ^2 = 11.45, P 〈 0.01 ;χ^2 = 34.56, P 〈 0.01 ） , and 6 - 36 months old group was significantly higher than the other 2 groups （χ^2 = 7. 590, P 〈 0.01 ;χ^2 = 6.928, P 〈 0.01 ）. Conchtsions Bordetella pertussis is an important pathogen for the infants with persistent cough ,especially in unvaccinated or incompletely vaccinated infants, but the clinical manifestation and signs of pertussis are atypical, which may lead to a misdiagnosis and delay proper treatment. As a rapid and sensitive method of detecting Bordetella pertussis,PCR may be used for early diagnosis.
出处
《中华实用儿科临床杂志》
CAS
CSCD
北大核心
2014年第22期1724-1727,共4页
Chinese Journal of Applied Clinical Pediatrics
