小儿肺炎伴类百日咳综合征临床特征及年龄差异性探讨

Clinical characteristics and age difference investigation of pneumonia children with pertussis like syndrome

目的探讨小儿肺炎伴类百日咳综合征临床特征及年龄差异性,为后续防治工作提供更多依据。方法回顾性分析我院2014年1月-2018年12月收治小儿肺炎伴类百日咳综合征患儿共118例临床资料,分析发病季节特点,并根据年龄分组后,比较不同年龄段患者合并症状、住院天数、实验室指标、病原学指标及混合感染情况。结果①不同年龄患儿肺炎伴类百日咳综合征发生率比较,具有显著性(P<0.05),且以3~<6月龄最高;女性患儿肺炎伴类百日咳综合征发病率显著高于男性(P<0.05);②患儿不同季节发生率比较差异具有显著性(P<0.05),且以夏季发病率最高;③不同年龄患儿喘息、发热及多肺叶受累比例比较差异具有显著性(P<0.05);喘息和发热症状比例以≥12月龄最高,而多肺叶受累比例则以4周~3月龄最高;④不同年龄患儿住院时间比较差异无显著性(P>0.05);⑤不同年龄患儿WBC计数、CRP升高比例、PLT升高比例及淋巴细胞比例比较,差异具有显著性(P<0.05);其中白细胞计数、PLT升高比例及淋巴细胞比例以3~<6月龄患儿最高,而CRP增高比例以4周~<3月龄组最高;⑥118例肺炎伴类百日咳综合征患儿中共检出病原体74例,检出率为62.71%;不同年龄患儿病毒和肺炎支原体检出率比较,差异具有显著性(P<0.05),其中病毒检出率中,3~<6月龄患儿检出率最高,肺炎支原体中6~<12月龄患儿检出率最高;不同年龄患儿细菌检出率比较差异具有显著性(P<0.05);⑦不同年龄患儿混合感染发生率比较,差异具有显著性(P<0.05),其中6~<12月龄患儿发生率最高;≥12月龄患儿细菌+肺炎支原体比例高于其他组(P<0.05)。结论肺炎伴类百日咳综合征患儿多为<6月龄,且好发于夏季,以阵发性痉挛性咳嗽症状最为常见;病毒、细菌及肺炎支原体均可能诱发犯病,且相当部分属于混合感染。

Objective To investigate the clinical characteristics and age difference of pneumonia children with pertussis like syndrome to providing more basis for the follow-up prevention and control work.Methods The clinical data of 118 pneumonia children with pertussis like syndrome were retrospectively chosen from January 2014 to December 2018,and the seasonal disease characteristics were analyzed,and the symptoms,hospitalization days,laboratory indexes,etiology indexes and mixed infection of patients in different age groups were compared.Results①There were significant difference in the incidence of pneumonia with pertussis like syndrome of children in different ages(P<0.05)and the highest one was 3~<6 months.The incidence of pneumonia with pertussis like syndrome in female was significantly higher than male(P<0.05).②There was significant difference in the incidence of children in different seasons(P<0.05)and the highest one was summer.③There were significant difference in the proportion of wheezing,fever and multiple lobes in children of different ages(P<0.05).The children with≥12 months possessed the highest proportion of wheezing and fever,while the children with 4 weeks-3 months possessed the highest proportion of multiple lobes lesion.④There was no significant difference in the hospitalization time of children in different ages(P>0.05).⑤There were significant differences in WBC count,CRP rising proportion,PLT rising proportion and lymphocyte ratio among children of different ages(P<0.05)and which children with 3~<6 months possessed the highest WBC count,PLT elevation and lymphocyte ratio and children with 4 weeks~<3 months possessed the highest CRP rising proportion.⑥118 pneumonia children with pertussis like syndrome included 74 case with pathogens and the detection rate was 62.71%.There were the significant difference in the detection rate of virus and mycoplasma pneumoniae among children at different ages(P<0.05),among which the detection rate of 3~<6 month children in virus and 6~<12 month children in mycoplasma pneumoniae were the highest.There were significant difference in the detection rate of bacteria among children at different ages(P<0.05).⑦There were significant difference in the incidence of mixed infection among children at different ages(P<0.05),which the incidence of children with 6~<12 months was the highest.The proportion of bacteria+mycoplasma pneumoniae in children with≥12 months was higher than other children(P<0.05).Conclusion Most pneumonia children with pertussis like syndrome are less than 6 months old,and they are prone to summer.Paroxysmal spasmodic cough is the most common symptom.Virus,bacteria and Mycoplasma pneumoniae all may cause diseases occurrence,and lots of them are mixed infection.