Xu M, Lei Y L, Tan K, Deng J K
Zunyi Medical University, Zunyi 563003, China.
Zhonghua Er Ke Za Zhi. 2018 Sep 2;56(9):686-690. doi: 10.3760/cma.j.issn.0578-1310.2018.09.010.
To investigate the clinical characteristics of pertussis-associated pneumonia and analyze it's risk factors. Clinical data were taken from Shenzhen Children's Hospital with infection and confirmed by culture or real-time polymerase chain reaction (PCR) of nasopharyngeal secretion from October 2013 to December 2015. Patients were divided into two groups, those with radiologically confirmed pneumonia in the course of their disease and those with not. Clinical data were retrospectively analyzed and compared. test, Rank sum test or chi square test were used for comparison between groups. Risk factors were analyzed by unconditional Logistic regression analysis. A total of 501 children hospitalized with infection were included. Among them, 309 patients were diagnosed with pneumonia. The median age was 3 (2, 6) months. Symptoms were paroxysmal cough (252, 81.6%), tachypnea (69, 22.3%), and cyanosis (105, 34.0%). The time from onset of cough to radiologically confirmed pneumonia was between 1 and 66 days with a median of 9 (5.5, 15.0) days. The most common pathogen of coinfection was respiratory syncytial virus (RSV)(20 cases). Macrolides were used in 306 cases for (8.2±3.6) days. All cases showed significant improvement. There were more male children (62.1% (192/309) 50.3% (95/189) , χ(2)=6.768, 0.009), and more instances of comorbidities (13.3% (41/309) .5.8% (11/189) , χ(2)=6.957, 0.008) in the pneumonia group than in the other. The age was younger (3 (2,6) .4 (2,6) months, 32.91, 0.000) in pneumonia group than in the other. Male sex, younger age, and underlying disease were independent risk factors for pertussis-associated pneumonia (1.648, 1.486, 2.695, 0.008, 0.036, 0.005). Pneumonia, as a complication of pertussis, is very easy to see in hospitalized children. The duration of hospitalization is extensive. It is more likely to happen in children who are male, young, and having underlying diseases. Pneumonia is easy to occur in the first 2 weeks of the course of disease.
为探讨百日咳相关性肺炎的临床特征并分析其危险因素。收集2013年10月至2015年12月在深圳儿童医院感染且经鼻咽分泌物培养或实时聚合酶链反应（PCR）确诊的临床资料。将患者分为两组，一组为病程中经影像学确诊为肺炎的患者，另一组为未确诊肺炎的患者。对临床资料进行回顾性分析和比较。采用t检验、秩和检验或卡方检验进行组间比较。通过非条件Logistic回归分析危险因素。共纳入501例因感染住院的儿童。其中，309例患者被诊断为肺炎。中位年龄为3（2，6）个月。症状包括阵发性咳嗽（252例，81.6%）、呼吸急促（69例，22.3%）和发绀（105例，34.0%）。从咳嗽发作到经影像学确诊肺炎的时间为1至66天，中位时间为9（5.5，15.0）天。合并感染最常见的病原体是呼吸道合胞病毒（RSV）（20例）。306例患者使用大环内酯类药物治疗（8.2±3.6）天。所有病例均有明显改善。肺炎组男性儿童更多（62.1%（192/309）对50.3%（95/189），χ²=6.768，P=0.009），合并症发生率也更高（13.3%（41/309）对5.8%（11/189），χ²=6.957，P=0.008）。肺炎组年龄比另一组更小（3（2，6）个月对4（2，6）个月，t=32.91，P=0.000）。男性、年龄较小和基础疾病是百日咳相关性肺炎的独立危险因素（比值比分别为1.648、1.486、2.695，P值分别为0.008、0.036、0.005）。肺炎作为百日咳的并发症，在住院儿童中很常见。住院时间较长。在男性、年幼和有基础疾病的儿童中更易发生。肺炎易在病程的前2周内发生。
