0~3月龄小婴儿百日咳临床特征及重症危险因素分析  

Clinical characteristics of pertussis and risk factors for severe pertussis in infants aged 0-3 months

作　　者：刘芙蓉[1] 马烨 姚婷新[1] 甘路民[1] 谷芬[1] 肖耿吉[1] 于四景[1] 王梦荧 罗如平[1] 刘静[1] Liu Furong;Ma Ye;Yao Tingxin;Gan Lumin;Gu Fen;Xiao Gengji;Yu Sjing;Wang Mengying;Luo Ruping;Liu Jing(Department of Infectious Diseases,Hunan Children's Hospital,Changsha 410007,China)

机构地区：[1]湖南省儿童医院感染科,长沙410007

出　　处：《国际流行病学传染病学杂志》2024年第4期229-233,共5页International Journal of Epidemiology and Infectious Disease

基　　金：湖南省中医药管理局科研课题资助项目(C2024023)。

摘　　要：目的探讨0~3月龄小婴儿百日咳临床特征及重症百日咳的危险因素。方法回顾性分析2019—2021年湖南省儿童医院0~3月龄住院百日咳患儿143例(重症组23例,普通组120例)病例资料,采用多因素Logistic回归分析法分析小婴儿重症百日咳的危险因素。结果143例患儿中,新生儿0~28日龄10例(6.99%,10/143),男女比例为1.13∶1;重症百日咳的发病率为16.08%(23/143),发病较多的月份为4—6月份(24.48%,35/143)和7—9月份(38.46%,55/143)。34例(23.78%,34/143)有咳嗽患者接触史,入院前发病时间大于1周者113例。和普通组比较,重症组在发热、鸡鸣样尾音、WBC计数≥30×10^(9)/L、淋巴细胞百分比、肺实变方面差异有统计学意义(χ2=14.134、12.945和15.807,Z=-4.222,P均<0.001;确切概率法,P=0.002)。多因素Logistic回归分析发现,WBC计数≥30×10^(9)/L(OR=11.873,95%CI:2.054~68.630)、淋巴细胞百分比下降(OR=0.935,95%CI:0.883~0.989)是重症百日咳的危险因素。结论临床医师对于痉挛性咳嗽、咳嗽时面色发红/发绀患儿应该注意百日咳可能,做到及早诊断及治疗。0~3月龄百日咳小婴儿患者出现发热、WBC计数大于30×10^(9)/L、淋巴细胞百分比下降、肺实变时需警惕重症百日咳。Objective To investigate the clinical characteristics of infants aged O-3 months with pertussis and risk factors for severe pertussis.Methods The data of 143 hospitalized infants aged 0-3 months diagnosed with pertussis from 2019 to 2021 in Hunan Children's Hospital(23 cases in the severe group and 120 cases in the general group)were retrospectively analyzed.Multivariate Logistic regression analysis was used to identify the risk factors for severe pertussis in infants.Results Among 143 cases,10 were neonates aged 0-28 days(6.99%,10/143),the male to female ratio was 1.13:1.The incidence rate of severe pertussis was 16.88%(23/143),with peaks in cases occurring most frequently from April to June(24.48%,35/143)and from July to September(38.46%,55/143).A total of 34 cases(23.78%,34/143)had a history of exposure to coughing patients,and 113 cases had a duration of illness exceeding 1 week before admission.The severe group showed statistically significant differences in terms of fever,inspiratory whoop,WBC count≥30×10/L,lymphocyte ratio,pulmonary consolidation compared to the control group(2=14.134,12.945 and 15.807,Z=-4.222,all P<0.001;exact test,P=0.002).Multivariate Logistic regression analysis showed that WBC count≥30×10/L(OR=11.873,95%CI:2.054-68.630),decreased lymphocyte ratio(0R=0.935,95%CI:0.883-0.989)were independent risk factors for severe pertussis.Conclusions Clinicians should pay attention to pertussis in infants presenting with paroxysmal cough,cyanosis or redness during coughing,ensuring early diagnosis and treatment.In infants aged O-3 months,vigilance is required for severe pertussis when patients accompanied by fever,WBC count exceeding 30x10%/L,decreased lymphocyte ratio,or pulmonary consolidation.

关 键 词：百日咳 婴儿 重症病例 临床特征 危险因素 

分 类 号：R725.1[医药卫生—儿科]