关键词: 百日咳, 临床特征, 危险因素

Abstract: Objective　To explore the clinical characteristics of children with pertussis and the risk factors of severe pertussis in order to provide reference for clinical diagnosis and treatment. Methods　The Central Laboratory of the Capital Institute of Pediatrics was used as the testing center to review the case data of 114 inpatients with whooping cough diagnosed from January to December 2019. According to the severity of the children’s condition and whether they were associated with other pathogenic infections. 73 cases of whooping cough were included in the single pertussis group and 41 cases were in mixed infection group. A hundred cases were the common group and 14 cases in the severe group. Single factor comparisons were performed between the groups，and the risk factors of severe pertussis were analyzed by binary Logistic regression. Results　1）A total of 66 cases（62.2%） of whooping cough occurred in autumn and winter. The predominant children were ≤6 months old，with a total of 79 cases（69.3%）. Totally 89 cases（78.1%） were not immunized，and 25 cases（21.9%） were immunized. 2）Univariate analysis showed that the mixed infection group was more likely to have hypoxemia，three depression sign，fever，and pulmonary rales than the simple pertussis group（P＜0.05）. The proportion of patients who had a history of premature delivery，bruising after coughing，three depression sign，fever，pulmonary rales，pneumonia，and mixed infection in severe group was higher than that in the ordinary group（P＜0.05）. The mixed infection group and severe group had longer hospital stay than the single pertussis group and common group（P＜0.05）. The peak value of white blood cells in the severe group was higher than that in the common group（P＜0.05）. Logistic regression analysis showed that increased WBC peak was arisk factor for severe pertussis（OR＝1.096，P＜0.05）. 3）A total of 114 cases of confirmed children were treated with macrolide antibiotics. Only 10 cases（8.8%） were treated within 7 days of the disease course，and 33 cases（28.9%） were treated within 8 to 14 days of the disease course. The rest were treated more than 14 days of the course of disease，of which 5 severely ill children were treated more than 21 days. 4）Children with severe whooping cough who were less than 4 months old were prone to severe complications，such as pneumonia，whooping cough encephalopathy，and cardiopulmonary failure. Among them，8 children were treated with invasive ventilation. After active treatment，one child died，and therest were improved and discharged. Conclusion　Whooping cough is more common in the babies under 6 months old whoare not immunized and the babies often require hospitalization. The incidence of complications in younger babies with whooping cough is higher. Co-infection and delayed medication may aggravate whooping cough and extend the length of hospital stay. It helps to judge disease severity to monitor the peak value of white blood cells.

Key words: whooping cough, clinical features, risk factors