庄雪娥　陈琼华　郑敬阳

[關键词] 儿童;百日咳;回顾性分析;临床特征

[中图分类号] R725.6          [文献标识码] B          [文章编号] 1673-9701（2021）17-0065-04

Clinical characteristics of 88 children with pertussis

ZHUANG Xue′e   CHEN Qionghua   ZHENG Jingyang

Department of Respiratory Medicine， Quanzhou Children′'s Hospital in Fujian Province，Quanzhou   362000，China

[Abstract] Objective To analyze the clinical characteristics of pertussis in children and improve the understanding of pertussis. Methods The case data of 88 children with pertussis admitted to Quanzhou Children's Hospital from May 2018 to October 2019 were retrospectively collected and analyzed. They were divided into ≤3 months old group and >3 months old group according to the age. And they were divided into the immunized group and the non-immunized group according to whether or not to vaccinate. The clinical data of spastic cough， cyanosis， hospitalization days， and severe cases were compared. Results （1）The incidence of spastic cough in the ≤3 months group was 91.80%， which was higher than that of（59.25%）in the >3 months group（P<0.05）. The incidence of spastic cough in the non-immunized group was 88.40%，which was higher than that of 57.89% in the immunized group（P<0.05）. The incidence of cyanosis in the ≤3 months group was 57.37%，which was higher than that of 18.51% in the >3 months group（P<0.05）. The incidence of cyanosis in the non-immunized group was 56.52%，which was higher than that of （5.26%）in the immunized group（P<0.05）. （2） The hospital stay in the≤3 months group was 12 （9， 17.5） days， which was longer than that of （10 [8， 13] days） in the >3 months group（P<0.05）. The hospital stay in the non-immunized group was 12 （9， 17） days， which was longer than that （10 [7， 12] days） in the immunized group（P<0.05）. （3）The incidence of severe illness in the group ≤3 months old was 57.37%， which was higher than that of 25.92% in the >3 months group（P<0.05）. The incidence of severe illness was 55.07% in the non-immunized group，which was higher than that of（21.05%） in the immunized group（P<0.05）. Conclusion Pertussis occurs mostly in infants and young children， and the symptoms are non-specific. The diagnosis depends on the etiological diagnosis. Children ≤3 months of age who have not been immunized have many spastic coughs， have a long hospital stay， and are seriously ill.

[Key words] Children; Pertussis; Retrospective analysis; Clinical characteristics

百日咳是一种由百日咳鲍特杆菌感染引起的急性呼吸道疾病，是我国法定的乙类传染病，具有高度传染性，人群普遍易感，其中以婴幼儿多见，其临床表现轻重不一，可从轻微呼吸症状到危及生命。目前，虽然自20世纪50年代起，大多数国家就开始实施百日咳疫苗的免疫接种，使得百日咳感染率和发病率大大降低[1]。但近年来，其发病率呈增长趋势，可能与无细胞百日咳疫苗功效逐渐减弱、百日咳传播方式变化、百日咳杆菌变异及对大环内酯类药物产生耐药有关。根据2012年世界卫生组织的报道，200 868例百日咳病例中有近95%发生在发展中国家[2]。因为对百日咳杆菌未产生完全免疫，小婴儿成了发病率、住院率及死亡率最高的人群。

儿童百日咳发病率在近年来不断升高，引起了儿科医生的广泛关注[3]。由于临床表现不典型、百日咳检测手段局限及医务人员缺乏认识，往往容易发生早期误诊、漏诊。本研究回顾性分析2018年5月至2019年10月泉州市儿童医院收治的88例百日咳患儿的病例资料，对其临床特征进行分析，以提高对儿童百日咳的认识，达到早诊断、早治疗的目的，现报道如下。

1 资料与方法

1.1 一般资料

回顾分析泉州市儿童医院2018年5月至2019年10月收治的91例百日咳患儿的病例资料，其中病例资料完整者共88例，且为本地疾控中心认证确诊。纳入标准：①年龄<18岁者;②符合中华医学会儿科学分会感染组制定的百日咳诊断标准[4]者;③临床资料完整者。排除标准[4]：合并结核、真菌等特殊病原学感染者。根据年龄将患儿分为≤3月龄组及>3月龄组;根据是否接种疫苗分为免疫组与非免疫组。若患……