Liru Cui, Jing Wang, Jing Bi, Yu Zhang, Jian Tian, Min Jiang
Department of Neonatology, Baoding Hospital of Beijing Children's Hospital, Capital Medical University, Baoding, Hebei Province, China.
Hebei Key Laboratory of infectious Diseases Pathogenesis and Precise Diagnosis and Treatment, Baoding, Hebei Province, China.
Ann Med. 2025 Dec;57(1):2514943. doi: 10.1080/07853890.2025.2514943. Epub 2025 Jun 17.
This study aims to analyze the clinical characteristics, treatment outcomes, and risk factors associated with respiratory support in infants hospitalized with pertussis.
We retrospectively analyzed the clinical data of 0-1-year-old pertussis patients admitted to Baoding Hospital of Beijing Children's Hospital affiliated with Capital Medical University from January 2022 to May 2024. SPSS27.0 statistical software was used to analyze the differences in data among different groups of children with pertussis and to summarize their clinical characteristics. A multiple logistic regression model was used to analyze the clinical risk factors of the respiratory support group.
We enrolled 233 hospitalized children with pertussis. Children requiring respiratory support had lower vaccination rates and higher incidences of cyanosis, wheezing, and RSV infection. Logistic regression identified age, cyanosis after coughing, and IVIG use as independent predictors of respiratory support. Age was an independent protective factor: older children were less likely to require respiratory support (OR = 0.151). Compared with children aged ≥3 months, children aged <3 months had a higher history of contact with cough patients, with symptoms such as cyanosis after coughing, white blood cell counts (WBCs) ≥20 × 10/L, lymphocyte percentage ≥60%, and increased RSV infection incidence. Rates of respiratory support, bronchoscopy treatment, IVIG, tracheal intubation, and exchange transfusion treatment increased (all < 0.05).
Younger pertussis patients have more severe clinical manifestations, with significantly increased WBCs, and they are more likely to be infected with other viruses. Age is an independent protective factor, and the younger the patient, the more likely they are to require respiratory support. These findings highlight the need for early recognition and targeted interventions, particularly in younger infants with severe symptoms.
本研究旨在分析百日咳住院婴儿的临床特征、治疗结果以及与呼吸支持相关的危险因素。
我们回顾性分析了2022年1月至2024年5月在首都医科大学附属北京儿童医院保定医院收治的0至1岁百日咳患者的临床资料。使用SPSS27.0统计软件分析不同组百日咳患儿的数据差异，并总结其临床特征。采用多因素logistic回归模型分析呼吸支持组的临床危险因素。
我们纳入了233例住院百日咳患儿。需要呼吸支持的患儿疫苗接种率较低，发绀、喘息和呼吸道合胞病毒（RSV）感染的发生率较高。logistic回归分析确定年龄、咳嗽后发绀和静脉注射免疫球蛋白（IVIG）的使用是呼吸支持的独立预测因素。年龄是一个独立的保护因素：年龄较大的儿童需要呼吸支持的可能性较小（比值比[OR]=0.151）。与年龄≥3个月的儿童相比，年龄<3个月的儿童有更高的与咳嗽患者接触史，伴有咳嗽后发绀、白细胞计数（WBC）≥20×10⁹/L、淋巴细胞百分比≥60%以及RSV感染发生率增加。呼吸支持、支气管镜治疗、IVIG、气管插管和换血治疗的比率均增加（均P<0.05）。
年龄较小的百日咳患者临床表现更严重，白细胞显著增多，且更易感染其他病毒。年龄是一个独立的保护因素，患者年龄越小，越有可能需要呼吸支持。这些发现凸显了早期识别和针对性干预的必要性，尤其是对于症状严重的小婴儿。
