3月龄以下百日咳住院患儿临床特征分析

Clinical characteristics of pertussis in hospitalized children under 3 months

回顾性收集2011年3月至2023年2月首都儿科研究所附属儿童医院270例住院百日咳患儿的人口学及临床资料,其中男151例,女119例;发病年龄为10 d至11岁。270例住院患儿按照起病年龄分为两组,<3月龄(143例),≥3月龄(127例)。<3月龄组患儿重症肺炎和重症百日咳发生率分别为21.0%和38.5%,均高于≥3月龄组的7.9%和11.0%(均P<0.05);<3月龄组痉挛性咳嗽、咳嗽后呕吐、阵发性青紫、呼吸暂停和咳嗽后心率下降的发生率分别为86.7%、25.2%、38.5%、7.0%和16.8%,均高于≥3月龄组的76.4%、10.2%、15.7%、1.6%和1.6%(均P<0.05);<3月龄组合并低氧血症和呼吸衰竭的比例分别为36.4%和16.8%,均高于≥3月龄组的10.2%和7.1%(均P<0.05)。3月龄以下百日咳患儿更易发生咳嗽后呕吐、阵发性青紫、呼吸暂停、低氧血症、呼吸衰竭、咳嗽后心率下降、合并重症肺炎,更易进展为重症百日咳。

Demographic data and clinical data were collected retrospectively from patients with pertussis at the Children′s Hospital Affiliated to the Capital Institute of Pediatrics between March 2011 and February 2023.Among the 270 hospitalized patients,151 cases were male and 119 were female.The youngest age of admission was 10 days and the eldest age of admission was 11 years.The 270 hospitalized patients were divided into two groups according to onset age:<3 months(n=143)and≥3 months(n=127).For those in the<3-month-old group,the incidence of severe pneumonia and severe pertussis were 21.0%and 38.5%,respectively,both were significantly higher than those in≥3-month-old group(7.9%and 11.0%,both P<0.05).For those in the<3-month-old group,paroxysmal spasmodic cough,post-tussive vomiting,paroxysmal cyanosis,apnea,and decreased heart rate after coughing were 86.7%,25.2%,38.5%,7.0%and 16.8%,respectively,all were significantly higher than those in≥3-month-old group(76.4%,10.2%,15.7%,1.6%and 1.6%,all P<0.05).For those in the<3-month-old group,the incidence of hypoxemia,respiratory failure,were 36.4%,16.8%,respectively,and both were significantly higher than those in≥3-month-old group(10.2%,7.1%,P<0.05).It indicated that among the infants under 3 months,the incidence of vomiting after coughing,paroxysmal cyanosis,apnea,hypoxemia,respiratory failure,decreased heart rate after coughing and severe pneumonia were significantly higher than those above 3 months.Infants under 3 months were prone to severe pertussis.