南京地区儿童百日咳住院病例临床特征及预后分析  

Clinical characteristics and prognosis analysis of hospitalized cases of pertussis in children in Nanjing area

作　　者：秦厚兵 刘峰[1] 田曼[1] QIN Houbing;LIU Feng;TIAN Man(Department of Respiratory Medicine,Children s Hospital Affiliated to Nanjing Medical University,Nanjing 210019,China)

机构地区：[1]南京医科大学附属儿童医院呼吸科,江苏南京210019

出　　处：《现代医学》2025年第2期258-264,共7页Modern Medical Journal

摘　　要：目的:百日咳目前仍然是全球公共卫生威胁之一,近年来病例有所增加,婴幼儿和未接种疫苗人群是主要患病群体。本研究旨在分析描述南京地区百日咳患儿的常规血液和病原学检查结果,寻找影响预后的重要因素。方法:本研究采用回顾性研究设计,纳入2014年1月至2024年6月在南京医科大学附属儿童医院就诊并确诊为百日咳的儿童。利用随机森林模型寻找与儿童百日咳预后相关的特征因素。结果:研究共纳入123例百日咳患儿,其中男62例(50.40%),女61例(49.60%)。患儿中位数年龄为0.38岁,其中86例未满1岁(69.90%)。肺炎支原体(MP)合并感染率最高(13.80%)。血小板(PLT)的平均值为(513.73±170.56)×10^(9)·L^(-1),范围在113.00~911.00×10^(9)·L^(-1);淋巴细胞(LYMPH)的平均值为(12.09±7.39)×10^(9)·L^(-1),范围在0.90~30.53×10^(9)·L^(-1);胱抑素C(Cys-c)的平均值为(1.22±0.34)mg·L^(-1),范围在0.63~2.40 mg·L^(-1)。随机森林模型分析显示,PLT是预测儿童百日咳预后最重要的特征因素,其次是LYMPH和Cys-c。总体模型的袋外误差率(OOB Error)为12.20%,曲线下面积(AUC)为0.783。结论:PLT、LYMPH、Cys-c可能是预测儿童百日咳预后的重要特征因素。Objective:Pertussis remains a global public health threat,with cases increasing in recent years,mainly among infants and unvaccinated people.The purpose of this study was to analyze and describe the results of routine blood and etiology examination of children with pertussis in Nanjing area,and to find the important factors influencing the prognosis.Methods:Retrospective study design was used to include children diagnosed with pertussis who were admitted to the Children s Hospital of Nanjing Medical University from January 2014 to June 2024.The random forest model was used to find the characteristic factors associated with the prognosis of pertussis in children.Results:A total of 123 children with pertussis were included in the study,including 62 males(50.40%)and 61 females(49.60%).The median age of the patients was 0.38 years,of whom 86(69.90%)were less than 1 year old.Mycoplasma pneumoniae(MP)had the highest co-infection rate(13.80%).The mean value of platelets(PLT)was 513.73±170.56×10^(9)·L^(-1),ranging from 113.00 to 911.00×10^(9)·L^(-1).The average LYMPH score was 12.09±7.39×10^(9)·L^(-1),and the lymph score ranged from 0.90 to 30.53×10^(9)·L^(-1).The mean value of cystatin C(Cys-c)was 1.22±0.34 mg·L^(-1),ranging from 0.63 to 2.40 mg·L^(-1).Random forest model analysis showed that PLT was the most important characteristic factor for predicting the prognosis of pertussis in children,followed by LYMPH and Cys-c.The overall model has an out-of-pocket Error rate(OOB)of 12.20%and an area under the curve(AUC)of 0.783.Conclusion:PLT,LYMPH and Cys-c may be important prognostic factors for children with pertussis.

关 键 词：儿童 百日咳 预后 随机森林 

分 类 号：R725.1[医药卫生—儿科]