类百日咳综合征与百日咳患儿临床症状、实验室指标及肺功能比较分析

Comparative Analysis of Clinical Symptoms,Laboratory Indexes and Pulmonary Function in Children with Pertussis-like Syndrome and Pertussis

目的 探讨类百日咳综合征与百日咳患儿临床症状、实验室指标及肺功能的差异。方法 选取2019年1月~2021年5月在郑州大学附属儿童医院收治的96例类百日咳综合征患儿的临床资料,及郑州市第六人民医院收治的39例百日咳患儿的临床资料,进行回顾性分析。比较百日咳和类百日咳综合征患儿临床症状、实验室及肺功能指标差异。结果 类百日咳综合征组百日咳疫苗接种史比例为90.63%,明显高于百日咳组的38.46%(P<0.05)。类百日咳综合征组患儿白细胞计数(white blood cell count,WBC)为(15.19±2.31)×10^(9)/L明显低于百日咳组(P<0.05)。类百日咳综合征组患儿呼吸比(the ratio of inspiratory time and expiratory time,TI/TE)、达峰时间比(atio of the time to reach peak tidal expiratiry flow to total expiratory time,TPTEF/TE)和达峰容积比(ratio of the volume to reach peak tidal expiratory flow to total expiratory time,VPEF/VE)分别为0.77%±0.08%、26.42%±4.23%和27.69%±3.47%,明显高于百日咳组的0.69%±0.10%、22.15%±3.56%和22.30%±3.81%(P<0.05)。WBC、TI/TE、TPTEF/TE和VPEF/VE鉴别诊断类百日咳综合征的ROC曲线下面积分别为0.750、0.723、0.729和0.771(P<0.05)。结论 类百日咳综合征和百日咳患儿在百日咳疫苗接种史、血常规WBC及肺功能方面有一定差异,可为鉴别诊断提供参考依据。

Objective To explore the differences in clinical symptoms,laboratory indicators and lung function between children with pertussis-like syndrome and pertussis.Methods The clinical data of 96 children with pertussis-like syndrome admitted in the Children′s Hospital of Zhengzhou University from January 2019 to May 2021,and the clinical data of 39 children with pertussis admitted to the Sixth People′s Hospital of Zhengzhou were selected for retrospective analysis analyze.The clinical symptoms and experiments of children with whooping cough and whooping cough-like syndrome.Differences in ventricular and lung function indicators were compared.ResultsThe proportion of pertussis vaccination history in the pertussis-like syndrome group was 90.63%,which was significantly higher than that in the pertussis group 38.46%(P<0.05).The white blood cell count(WBC) of children with pertussis-like syndrome was(15.19±2.31)×10~9/L,which was significantly lower than that of the pertussis group(P<0.05).The respiratory ratio(TI/TE),peak time ratio(TPTEF/TE) and peak volume ratio(VPEF/VE) of children with pertussis-like syndrome were 0.77%±0.08%,26.42%±4.23% and 27.69%±3.47%,which was significantly higher than the pertussis group 0.69%±0.10%,22.15%±3.56% and 22.30%±3.81%(P<0.05).The area under the ROC curve for differential diagnosis of pertussis-like syndrome in WBC,TI/TE,TPTEF/TE and VPEF/VE were 0.750,0.723,0.729 and 0.771(P<0.05).Conclusion There are certain differences between pertussis-like syndrome and pertussis in children with pertussis vaccination history,blood routine WBC and lung function,which can provide a reference for the differential diagnosis.