新生儿类百日咳16例临床特征分析

The clinical features of pertussis-like syndrome in 16 newborns

目的探讨新生儿类百日咳的临床特征。方法回顾性分析2014-01～2016-12在该院新生儿科收治的16例新生儿类百日咳患儿的临床资料。结果该研究共纳入16例研究对象,其中男婴9例,女婴7例;早产儿2例;发病日龄在12～27 d,16例新生儿类百日咳患儿均有阵发性痉咳表现,10例有咳嗽患者接触史,3例有发热,7例咳嗽伴有吸气性鸡鸣样回声,5例早期有鼻塞、流涕等症状。13例患儿外周血白细胞计数升高,淋巴细胞升高者10例。10例患儿深部痰培养阳性,合并呼吸道合胞病毒感染5例。16例患儿在常规抗感染基础上,根据实验室及病原学检查结果阳性者予以红霉素治疗,部分患儿治疗后仍痉咳明显,予丙种球蛋白治疗,16例患儿痉咳均明显改善后出院,无死亡病例。结论新生儿类百日咳与新生儿百日咳临床症状相似,对于出现阵发性痉咳,外周血白细胞升高,且以淋巴细胞升高为主的新生儿,应先行百日咳鲍特菌PCR检测,警惕类百日咳的可能,及时诊治,降低病死率。

Objective To explore the clinical features of pertussis-like syndrome in newborns. Methods The clinical data of 16 newborns with neonatal pertussis-like syndrome admitted to our department during January 2014 and December 2016 were analyzed. Results A tatal of 16 samples were in clueled in the study. There were 9 male infants, 7 female infants and 2 premature infants. The onset time was 12 to 27 days. All of the cases had paroxysmal cough. 10 cases had a history of exposure to cough. 3 cases had fever. 7 cases had crow-like echo. 5 cases showed early nasal congestion and runny nose. The peripheral white blood cell count was increased in 13 cases and lymphocytes increased in 10 cases. 10 cases had positive deep sputum culture. 5 cases had respiratory syncytial virus infections. Some patients were treated with gamma globulin on the basis of erythromycin treatment. Convulsion and cough were improved in all the patients and they were discharged without any deaths. Conclusion Neonatal pertussis-like syndrome is similar to neonatal pertussis in the clinical symptoms. The newborns who have paroxysmal spasmodic cough, increasing peripheral blood white blood cells, and the rise of lymphocytes should have the Bordetella Pertussis PCR test to confirm the neonatal pertussis-like syndrome, and are treated timely.