慢性咳嗽患儿百日咳感染与非感染临床特征分析

摘要

Objective To compare clinical features of pertussis infection and non-pertussis infection in children with chronic cough.Methods Clinical data of 189 children with chronic cough who were admitted from June 2013 to June 2017 in Xi'an Children's Hospital were retrospectively analyzed.Diagnosis of pertussis infection was defined as pertussis toxin immunoglobulin G ＞ 100 kU/L;the children were divided into pertussis group (40 cases) and non-pertussis group (149 cases).Clinical characteristics,laboratory indicators and imaging findings were analyzed.Results Sex,age,registered permanent residence,immunization of pertussis vaccine and length of cough had no significant differences between groups(P ＞ 0.05).Incidences of lymphocyte abnormality,leukocyte abnormality,fever,paroxysmal cough,expectoration,cyanosis,echoes,short of breath had no significant differences between groups(P ＞ 0.05).Incidences of conjunctival bleeding,pneumonia and asphyxia in pertussis group were significantly higher than those in non-pertussis group[20.0％ (8/40) vs 2.7％ (4/149),100.0％(40/40) vs 75.2％ (112/149),15.0％ (6/40) vs 2.7％ (4/14)] (P ＜0.01).Logistic regression analysis showed that conjunctival bleeding,pneumonia and asphyxia were independent features of pertussis infection in children with chronic cough (P ＜ 0.01).Conclusion Pertussis infection is one of important causes of chronic cough in children;conjunctival bleeding,pneumonia and asphyxia may be independent features of oertussis infection in differential diagnosis of chronic cough with or without pertussis infection.%目的 分析慢性咳嗽患儿百日咳感染与非感染的临床特征.方法 收集2013年6月至2017年6月西安市儿童医院收治的189例慢性咳嗽患儿的病历资料,依据是否有百日咳感染情况(百日咳感染标准为百日咳毒素免疫球蛋白G＞ 100 kU/L),分为百日咳组(40例)和非百日咳组(149例)例.通过问卷调查及相关实验室和影像学指标检查,统计分析所有患儿的临床特征.结果 2组性别、年龄、户籍、免疫接种情况、咳嗽时间比较,差异无统计学意义(P＞0.05).2组淋巴细胞异常、白细胞异常、发热、阵发咳嗽、咳痰、紫绀、鸡鸣回声、憋气的发生率基本相同,差异无统计学意义(P＞0.05).百日咳组球结膜出血、肺炎、窒息的发生率明显高于非百日咳组[20.0％ (8/40)比2.7％ (4/149)、100.0％ (40/40)比75.2％(112/149)、15.0％(6/40)比2.7％(4/149)],差异有统计学意义(P＜0.01).Logistic回归分析结果显示,球结膜出血、肺炎、窒息是慢性咳嗽患儿百日咳感染的独立影响特征(P＜0.01).结论 百日咳感染是引起儿童慢性咳嗽的重要原因之一,其与非感染患儿存在相似的临床特征;而球结膜出血、肺炎、窒息是百日咳感染的独立影响特征,可能有利于早期排查百日咳感染的发生.