痉挛性咳嗽患儿百日咳鲍特菌感染状况及临床特征分析

Analysis on the Infection Status and Clinical Characteristics of Bordetella Pertussis in Children with Spasmodic Cough

目的:了解痉挛性咳嗽患儿百日咳鲍特菌感染状况并分析其临床特征。方法:回顾性分析2019年1~12月于本院进行咽拭子聚合酶链式反应(PCR)及血清人百日咳毒素IgG抗体(PT-IgG)检测的疑似百日咳鲍特菌感染的痉挛性咳嗽患儿病历资料,根据检测结果分为百日咳组与类百日咳组,并比较两组患儿的临床特征。结果:共纳入147例痉挛性咳嗽患儿,百日咳组92例,类百日咳组55例。百日咳鲍特菌检测阳性率为62.6%。百日咳多发于0~3岁婴幼儿,一年四季均可发病,以春季和夏季居多。临床特征方面,百日咳组咳鸡鸣样回声、白细胞计数升高者多于类百日咳组(P<0.05);百日咳组合并鼻炎和(或)结膜炎者少于类百日咳组(P<0.05);两组咳嗽剧烈窒息、咳嗽剧烈发绀、咳嗽剧烈呕吐、合并肺炎/支气管炎者比较无统计学差异(P>0.05)。结论:PCR和血清学检测可相互辅助诊断痉挛性咳嗽,以免漏诊。对于伴有咳鸡鸣样回声、白细胞升高者,应警惕百日咳鲍特菌感染。

Objective:To investigate the infection status of Bordetella pertussis in children with spasmodic cough and analyze its clinical characteristics.Methods:The case data of children with spasmodic cough suspected of Bordetella pertussis infection detected by pharyngeal swab polymerase chain reaction(PCR)and serum human pertussis toxin Ig G antibody(PT-IgG)in our hospital from January to December 2019 were analyzed retrospectively.According to the test results,they were divided into pertussis group and pertussis-like group,and the clinical characteristics of the two groups were compared.Results:147 children with spasmodic cough were analyzed,including 92 case in the pertussis group and 55 case in the pertussis-like group.The positive rate of Bortella pertussis was 62.6%.Pertussis mostly occurs in infants aged 0~3 years.It occurs all year around,mostly in spring and summer.In terms of clinical characteristics,the number of cough with cock-like echo and the increase of leukocyte count in pertussis group were more than those in pertussis-like group(P<0.05).The incidence of pertussis combined with rhinitis and/or conjunctivitis in the pertussis group were less than those in the pertussis-like group(P<0.05).There was no significant difference between the two groups in cough severe asphyxia,cough severe cyanosis,cough severe vomiting and pneumonia/bronchitis(P>0.05).Conclusion:PCR and serological tests can be used to diagnose spasmodic cough in order to avoid missed diagnosis.Pertussis infection should be on the alert,if it is accompanied by cooing like echo and elevated leukocyte.