摘要
目的 探讨儿童重症百日咳的临床特征及其发生的影响因素。方法 回顾性收集2011年3月~2018年12月首都儿科研究所附属儿童医院收治的百日咳患儿的人口学及临床资料,根据百日咳的严重程度将患儿分为重症百日咳组和非重症百日咳组。比较两组间各指标,并探讨发生重症百日咳的影响因素。结果 在227例百日咳患儿中,重症百日咳组有54例(23.8%),非重症百日咳组有173例(76.2%)。重症百日咳组发病年龄低于非重症百日咳组[1.35(0.60, 2.36)个月vs 3.93(1.19, 7.67)个月,P<0.01]。重症百日咳组中有阵发性痉挛性咳嗽、咳嗽后呕吐、阵发性青紫、咳嗽时面色潮红及发热的发生率分别高于非重症百日咳组(96.3%vs 81.5%、31.5%vs 13.9%、81.5%vs 9.8%、98.2%vs 76.9%和51.9%vs 27.2%,P<0.05)。重症百日咳组完成全程接种百日咳疫苗的比例低于非重症百日咳组(1.9%vs 19.1%,P<0.01),而重症百日咳组的未接种疫苗比例高于非重症百日咳组(94.4%vs 69.4%,P<0.01)。逐步Logistic回归分析结果显示,完成全程接种百日咳疫苗为减少重症百日咳发生的保护性因素(OR=0.07,95%CI:0.008~0.610,P=0.02)。结论 年龄越小尤其<3月龄的百日咳患儿越容易进展为重症百日咳,完成全程接种百日咳疫苗是减少儿童重症百日咳发生的保护性因素。
Objective To explore the clinical characteristics of children with severe pertussis and the influencing factors for the development of severe pertussis.Methods The demographic data and clinical data of children with pertussis admitted to the Children′s Hospital,Capital Institute of Pediatrics between March 2011 and December 2018 were collected retrospectively.The patients were divided into two groups according to the severity of pertussis:severe pertussis group and non-severe pertussis group.The relevant indexes were compared between the two groups,and the influencing factors of severe pertussis were discussed.Results Among 227 children with pertussis,54(23.8%)were in the severe pertussis group,and 173 cases(76.2%)were in the non-severe pertussis group.The mean onset age of severe pertussis group was significantly lower that in the non-severe pertussis group[1.35(0.60,2.36)months vs 3.93(1.19,7.67)months,P<0.01].The incidence of the paroxysmal spasmodic cough,post-tussive vomiting,paroxysmal cyanosis,facial flushing during coughing,and fever were higher in the severe pertussis group than that in the non-severe pertussis group,and the differences were statistically significant(96.3%vs 81.5%,31.5%vs 13.9%,81.5%vs 9.8%,98.2%vs 76.9%and 51.9%vs 27.2%,P<0.05).The complete-vaccination proportion was significantly lower in the severe pertussis group than that in the non-severe pertussis group(1.9%vs 19.1%,P<0.01).The non-vaccination proportion was significantly higher in the severe pertussis group than that in the non-severe pertussis group(94.4%vs 69.4%,P<0.01).The results of Logistic regression analysis showed that complete-vaccination was a protective factor for diminishing the development of severe pertussis(OR=0.07,95%CI:0.008-0.610,P=0.02).Conclusion Infants<3months of age are prone to severe pertussis,and the younger the infant,the more severe pertussis.Complete-vaccination was a protective factor for diminishing the development of severe pertussis in children.
作者
康利民
米荣
崔小岱
伏瑾
王文鹏
李莉
李铁耕
王晓颖
肖飞
KANG Limin;MI Rong;CUI Xiaodai(Department of Neonatal Medicine,Children′s Hospital,Capital Institute of Pediatrics,Beijing 100020,China)
出处
《医学研究杂志》
2024年第4期97-100,96,共5页
Journal of Medical Research
基金
北京市自然科学基金资助项目(7192028)
北京市自然科学基金-海淀原始创新联合基金资助项目(L202022)。
关键词
百日咳鲍特菌
儿童
临床特征
Bordetella pertussis
Children
Clinical Characteristics
