百日咳患儿免疫水平及其危重因素分析  

Analysis of Immune Level and Critical Factors in Children with Pertussis

作　　者：邹春山[1] 郑铭城 谢楠楠[1] 林秀芝 庄姗姗 方金涌[1] ZOU Chunshan;ZHENG Mingcheng;XIE Nannan;LIN Xiuzhi;ZHUANG Shanshan;FANG Jinyong(People's Hospital of Jieyang City,Jieyang 522000,China)

机构地区：[1]广东省揭阳市人民医院,广东揭阳522000

出　　处：《中国医药指南》2021年第23期23-25,共3页Guide of China Medicine

基　　金：揭阳市科技计划项目(190825102354792)。

摘　　要：目的系统分析百日咳患儿的免疫水平及其危重因素,以期为百日咳患儿的临床诊疗提供理论指导与参考借鉴。方法选取2019年9月至2021年3月收治于我院的百日咳患儿150例作为研究对象,按照病情严重程度进行分组,分为重症百日咳组(n=65)及普通型百日咳组(n=85)。通过系统对比两组患儿间免疫水平相关指标的差异,并探明上述指标与病情严重程度之间的相关性,进而为百日咳患儿的临床诊疗提高参考借鉴。结果①重症百日咳组IgA、IgG、IgM、CD_(4)^(+)、CD_(4)^(+)/CD_(8)^(+)显著低于普通型百日咳组,而CD_(8)^(+)、补体C_(3)及C_(4)水平均显著高于普通型百日咳组(P<0.05);②单因素分析表明,外周血白细胞、C反应蛋白、CD_(8)^(+)、补体C_(3)及C_(4)水平过高,IgA、IgG、IgM、CD_(4)^(+)、CD_(4)^(+)/CD_(8)^(+)水平过低以及血小板过少等均是诱发百日咳病情加重的独立危险因素(P<0.05);③Logistic多元回归分析表明,CD_(8)^(+)、补体C_(3)及C_(4)水平与百日咳病情严重程度呈显著正相关关系(OR=1.263,P=0.002;OR=1.482,P=0.001;OR=1.663,P=0.001);IgA、IgG以及CD_(4)^(+)与百日咳病情严重程度呈显著负相关关系(OR=-1.011,P=0.002;OR=-1.326,P=0.001;OR=-1.620,P=0.002)。结论百日咳患儿的免疫水平与健康对照存在显著差异,免疫相关指标的变化与病情严重程度息息相关。Objective To systematically analyze the immune level and critical factors of children with pertussis,in order to provide theoretical guidance and reference for the clinical diagnosis and treatment of children with pertussis.Methods A total of 150 children with pertussis who were admitted to our hospital from September 2019 to March 2021 were selected as the research subjects.According to the severity of the disease,they were divided into severe pertussis group(n=65)and normal pertussis group(n=85).Through the systematic comparison of the differences between the two groups of children with immune level related indicators,and to explore the correlation between the above indicators and the severity of the disease,so as to improve the clinical diagnosis and treatment of children with pertussis for reference.Results(1)The levels of IgA,IgG,IgM,CD_(4)^(+),CD_(4)^(+)/CD_(8)^(+)in severe pertussis group were significantly lower than those in normal pertussis group,while the levels of CD_(8)^(+),complement C_(3) and C_(4) were significantly higher than those in normal pertussis group(P<0.05).(2)Unifactorial analysis showed that high levels of peripheral white blood cells,C-reactive protein,CD_(8)^(+),complement C_(3) and C_(4),low levels of IgA,IgG,IgM,CD_(4)^(+),CD_(4)^(+)/CD_(8)^(+)and thrombocytopenia were independent risk factors for exacerbation of pertussis(P<0.05).(3)Logistic multiple regression analysis showed that the levels of CD_(8)^(+),complement C_(3) and C_(4) were positively correlated with the severity of pertussis(OR=1.263,P=0.002;OR=1.482,P=0.001;OR=1.663,P=0.001);IgA,IgG and CD_(4)^(+)were significantly negatively correlated with the severity of pertussis(OR=-1.011,P=0.002;OR=1.326,P=0.001;OR=-1.620,P=0.002).Conclusion The immune level of children with pertussis is significantly different from that of healthy controls,and the changes of immune-related indexes are closely related to the severity of the disease.

关 键 词：百日咳 免疫水平 危重因素 相关性分析 病情严重程度 

分 类 号：R516.6[医药卫生—内科学]