摘要
回顾性分析济宁医学院附属医院2023年1月至2024年12月收治的成人百日咳肺炎患者资料,利用莱斯特咳嗽问卷(LCQ)分析患者咳嗽严重程度和生活质量下降情况,并对患者临床表现、影像学特征及支气管镜下表现进行总结。共纳入24例成人百日咳肺炎患者,男13例,女11例,年龄(56.0±15.9)岁,均以咳嗽为主诉。以呼出气一氧化氮(FeNO)水平,分为FeNO升高组[>25 ppb(1 ppb=1×10^(-9))]和FeNO正常组(5~25 ppb)。24例患者LCQ总评分为(10.6±3.1)分。女性LCQ总评分[(8.9±2.8)比(12.1±2.5)分]及心理评分[(2.8±1.5)比(4.5±1.7)分]均低于男性(均P<0.05);FeNO升高组LCQ总评分[(8.7±2.3)比(11.2±3.1)分]、心理评分[(2.6±0.8)比(4.1±1.6)分]均低于FeNO正常组(均P<0.05)。24例患者胸部CT表现为支气管壁增厚(79.1%,19/24)、斑片状浸润影(54.2%,13/24)、肺实变影(45.8%,11/24)、肺内条索影(29.2%,7/24)、树芽征(16.7%,4/24)及磨玻璃密度影(12.5%,3/24)。支气管镜下均可见黏膜充血水肿(100%,24/24),部分见脓性分泌物(66.7%,16/24)、黏液栓堵塞(20.8%,5/24)、管腔炎性狭窄(8.3%,2/24)、黏膜糜烂(4.2%,1/24)及黏膜白斑(4.2%,1/24)。成人百日咳肺炎以咳嗽为主诉,LCQ评分下降,FeNO升高组较正常组LCQ评分低,影像学表现为支气管炎、肺炎,支气管镜下病变轻重不等。经常规治疗效果不佳的成人咳嗽患者需警惕百日咳感染。
The data of adult whooping cough pneumonia patients admitted to the Affiliated Hospital of Jining Medical College from January 2023 to December 2024 were retrospectively analyzed,and the Leicester Cough Questionnaire(LCQ)was used to analyze the severity of the patients′cough and the decline of their quality of life,and to summarize the clinical manifestation,imaging feature,and bronchoscopic manifestation.A total of 24 adult patients with whooping cough,13 males and 11 females,aged(56.0±15.9)years,were included,and all of them had cough as the cheif complaint.Using fractional exhaled nitric oxide(FeNO)levels,they were divided into the elevated FeNO group[>25 ppb(1 ppb=1×10^(-9)))and the normal FeNO group(5-25 ppb).The total LCQ score of the 24 patients was(10.6±3.1)points.The total LCQ score[(8.9±2.8)vs(12.1±2.5)points]and psychological score[(2.8±1.5)vs(4.5±1.7)points]of females were lower than those of males(all P<0.05);the total LCQ score[(8.7±2.3)vs(11.2±3.1)points]and psychological score[(2.6±0.8)vs(4.6±1.6)points]of the FeNO elevation group were lower than those of the FeNO normal group(all P<0.05).Chest CT in the 24 patients showed bronchial wall thickening(79.1%,19/24),patchy infiltrating shadow(54.2%,13/24),solid lung shadow(45.8%,11/24),intrapulmonary striated shadow(29.2%,7/24),and dendritic sign(16.7%,4/24)and ground glass density shadow(12.5%,3/24).Bronchoscopy showed mucosal congestion and edema in all cases(100%,24/24),and in some cases,purulent secretion(66.7%,16/24),mucus plug(20.8%,5/24),inflammatory stenosis of the lumen(8.3%,2/24),mucosal erosions(4.2%,1/24),and mucosal leukoplakia(4.2%,1/24).Whooping cough in adults was characterized by cough as the cheif complaint,decreased LCQ score,lower LCQ score in the elevated FeNO group compared to the normal FeNO group,and imaging manifestations of bronchiolitis,pneumonia,and bronchoscopic lesions of varying severity.Adult patients with cough who do not respond well to conventional treatment need to be alerted to pertussis infection.
作者
刘泽茹
葛继文
孔凯
吕高超
蒋胜华
Liu Zeru;Ge Jiwen;Kong Kai;Lyu Gaochao;Jiang Shenghua(Department of Respiratory and Critical Care Medicine,Affiliated Hospital of Jining Medical University,Jining 272029,China;Department of Public Health,Affiliated Hospital of Jining Medical University,Jining 272029,China)
出处
《中华医学杂志》
北大核心
2025年第30期2573-2576,共4页
National Medical Journal of China
基金
济宁市重点研发计划(2024YXNS054)
济宁医学院附属医院“苗圃”科研计划(MP-MS-2023-16)。
关键词
百日咳
成人
莱斯特咳嗽问卷
Whooping cough
Adult
Leicester cough questionnaire
