摘要
目的 探讨儿童重症百日咳的临床特征及其发生的影响因素.方法 回顾性收集 2011 年 3 月～2018 年 12 月首都儿科研究所附属儿童医院收治的百日咳患儿的人口学及临床资料,根据百日咳的严重程度将患儿分为重症百日咳组和非重症百日咳组.比较两组间各指标,并探讨发生重症百日咳的影响因素.结果 在 227 例百日咳患儿中,重症百日咳组有 54 例(23.8%),非重症百日咳组有 173 例(76.2%).重症百日咳组发病年龄低于非重症百日咳组[1.35(0.60,2.36)个月 vs 3.93(1.19,7.67)个月,P<0.01].重症百日咳组中有阵发性痉挛性咳嗽、咳嗽后呕吐、阵发性青紫、咳嗽时面色潮红及发热的发生率分别高于非重症百日咳组(96.3%vs 81.5%、31.5%vs 13.9%、81.5%vs 9.8%、98.2%vs 76.9%和 51.9%vs 27.2%,P<0.05).重症百日咳组完成全程接种百日咳疫苗的比例低于非重症百日咳组(1.9%vs 19.1%,P<0.01),而重症百日咳组的未接种疫苗比例高于非重症百日咳组(94.4%vs 69.4%,P<0.01).逐步 Logistic回归分析结果显示,完成全程接种百日咳疫苗为减少重症百日咳发生的保护性因素(OR =0.07,95%CI:0.008～0.610,P =0.02).结论 年龄越小尤其<3 月龄的百日咳患儿越容易进展为重症百日咳,完成全程接种百日咳疫苗是减少儿童重症百日咳发生的保护性因素.
Abstract
Objective To explore the clinical characteristics of children with severe pertussis and the influencing factors for the de-velopment of severe pertussis.Methods The demographic data and clinical data of children with pertussis admitted to the Children's Hospital,Capital Institute of Pediatrics between March 2011 and December 2018 were collected retrospectively.The patients were divided into two groups according to the severity of pertussis:severe pertussis group and non-severe pertussis group.The relevant indexes were compared between the two groups,and the influencing factors of severe pertussis were discussed.Results Among 227 children with per-tussis,54(23.8%)were in the severe pertussis group,and 173 cases(76.2%)were in the non-severe pertussis group.The mean on-set age of severe pertussis group was significantly lower that in the non-severe pertussis group[1.35(0.60,2.36)months vs 3.93(1.19,7.67)months,P<0.01].The incidence of the paroxysmal spasmodic cough,post-tussive vomiting,paroxysmal cyanosis,fa-cial flushing during coughing,and fever were higher in the severe pertussis group than that in the non-severe pertussis group,and the differences were statistically significant(96.3%vs 81.5%,31.5%vs 13.9%,81.5%vs 9.8%,98.2%vs 76.9%and 51.9%vs 27.2%,P<0.05).The complete-vaccination proportion was significantly lower in the severe pertussis group than that in the non-se-vere pertussis group(1.9%vs 19.1%,P<0.01).The non-vaccination proportion was significantly higher in the severe pertussis group than that in the non-severe pertussis group(94.4%vs 69.4%,P<0.01).The results of Logistic regression analysis showed that complete-vaccination was a protective factor for diminishing the development of severe pertussis(OR =0.07,95%CI:0.008-0.610,P =0.02).Conclusion Infants<3months of age are prone to severe pertussis,and the younger the infant,the more severe pertussis.Complete-vaccination was a protective factor for diminishing the development of severe pertussis in children.
基金项目
北京市自然科学基金(7192028)
北京市自然科学基金-海淀原始创新联合基金(L202022)
NETL
NSTL
万方数据