儿童百日咳的临床特点和诊断预测因素分析  

Analysis of Clinical Characteristics and Diagnosis Predictive Factors of Pertussis in Children

作　　者：陈沫[1] 温琼[1] CHEN Mo;WEN Qiong(Department of Paediatrics,Fifth Affiliated Hospital of Zhongshan University,Zhuhai,Guangdong Province,519000 China)

机构地区：[1]中山大学附属第五医院儿科,广东珠海519000

出　　处：《系统医学》2021年第21期1-4,共4页Systems Medicine

基　　金：珠海市科技计划项目(20181117A010017)。

摘　　要：目的探讨儿童百日咳的临床特点,并进行早期诊断的预测因素分析。方法收集2018年7月—2020年7月在中山大学附属第五医院儿科疑诊百日咳的84例患儿住院病历资料,按呼吸道分泌物百日咳PCR检测是否阳性分为百日咳组和类百日咳组,比较两组患儿的临床特点,并进一步行Logistic回归分析探讨诊断的独立预测因素。结果共有84例患儿纳入研究,其中百日咳组38例,类百日咳组46例,两组患儿未接种疫苗、鸡鸣样回声和白细胞计数>15×10^(9)/L的比例相比较,差异有统计学意义(χ^(2)=11.780、11.246、4.497,P<0.05);进一步Logistic回归分析,发现未接种疫苗和鸡鸣样回声是诊断百日咳的独立预测因素。百日咳组患儿白细胞计数和淋巴细胞计数较类百日咳组增高,差异有统计学意义(t=2.400、2.423,P<0.05)。结论儿童百日咳临床表现多样,临床上对这些诊断的预测因素早期识别和干预,能够改善患儿预后。Objective To investigate the clinical characteristics of pertussis in children and analyze the predictors of early diagnosis.Methods The inpatient medical records of 84 children who were suspected of pertussis in the pediatric department of the fifth hospital of Zhongshan university from July 2018 to July 2020 were collected.According to whether the PCR test of respiratory secretions was positive or not,they were divided into pertussis group and pertussislike group.The clinical characteristics of the two groups of children were compared,and logistic regression analysis was performed to explore the independent predictive factors of diagnosis.Results A total of 84 children were included in the study.Among them,the pertussis group 38 cases and the pertussis-like group 46 cases were compared in the ratio of unvaccinated,chicken-like echo and white blood cell count >15×10^(9)/L,the difference was statistically significant(χ^(2)=11.780,11.246,4.497,P<0.05).Further logistic regression analysis showed that no vaccination and cock-like echo were independent predictors of whooping cough.The white blood cell count and lymphocyte count of children in the pertussis group were higher than those in the pertussis-like group,and the difference was statistically significant(t=2.400,2.423,P<0.05).Conclusion The clinical manifestations of pertussis in children are varied.Early recognition and intervention of these predictors can improve the prognosis of children with pertussis.

关 键 词：百日咳 儿童 临床特点 诊断预测 

分 类 号：R725[医药卫生—儿科]