Abstract: Objective　To investigate the etiology and clinical characteristics of pertussis-like syndrome. Methods　The nasopharyngeal secretions collected from patients with pertussis-like symptom in Children’s Hospital Affiliated to Soochow University from February 2016 to December 2017 were detected for pertussis DNA using PCR assays and other microbiological assessment. Results　A total of 197 children were enrolled in the study，of whom 119（60.4%） patients were positive for Bordetella pertussis，and 37 cases（37.8%） were positive for other pathogens，including 14 cases（37.8%） of rhinovirus，14 cases（37.8%） of Mycoplasma pneumoniae，4 cases（10.8%） of human bocavirus，3 cases（8.1%） of parainfluenza virus and 1 case（2.7%） of respiratory syncytial virus，and 1 case（2.7%） of Haemophilus influenzae. There were no significant differences in mean age，paroxysmal cough，inspiratory whoop，posttussive vomiting，paroxysmal cyanosis，or pulmonary signs between pertussis group and pertussis-like syndrome group（P＞0.05）. The proportion of male in pertussis group（57.1% vs. 35.3%），white blood cell counts［（18.83±11.54）×109/L vs. （12.46±6.01）×109/L）］，lymphocyte counts［（10.62±8.48）×109/L vs. （6.54±5.13）×109/L）］ were significantly higher than those in pertussis-like syndrome group（P＜0.05）. Conclusion　Rhinovirus and Mycoplasma pneumoniae are the main pathogens of pertussis-like syndrome. Leukocyte and lymphocyte counts can be used as an index to differentiate pertussis from pertussis-like syndrome.

Key words: Bordetella pertussis；pertussis-like syndrome；child, pathogen；clinical characteristics

摘要： 目的　探讨类百日咳综合征的病原学及其临床特点。方法　对2016年2月至2017年12月苏州大学附属儿童医院可疑百日咳住院患儿进行痰百日咳博德特菌聚合酶链式反应（PCR）检测、细菌培养、呼吸道病毒抗原及血清肺炎支原体抗体检测。结果　共有197例患儿纳入研究，其中119例（60.4%）百日咳博德特菌PCR检测阳性，78例百日咳检测阴性的标本中，其他病原检测阳性者37例，其中鼻病毒14例（37.8%），肺炎支原体14例（37.8%），博卡病毒4例（10.8%），副流感病毒3型3例（8.1%），呼吸道合胞病毒1例（2.7%），流感嗜血杆菌1例（2.7%）。百日咳组患儿的平均年龄、痉挛样咳嗽、鸡鸣样回声、咳后呕吐、阵发性青紫、并发症及肺部体征比较差异均无统计学意义（P＞0.05）。百日咳组男性患儿的比例（57.1% vs. 35.3%）、白细胞计数［（18.83±11.54）×109/L vs. （12.46±6.01）×109/L］、淋巴细胞计数［（10.62±8.48） ×109/L vs. （6.54±5.13×109/L］明显高于类百日咳组，差异均有统计学意义（P＜0.05）。结论　鼻病毒和肺炎支原体是引起类百日咳综合征的主要病原，白细胞和淋巴细胞计数可作为临床初步区别百日咳与类百日咳的一个指标。

关键词: 百日咳杆菌, 类百日咳综合征, 儿童, 病原, 临床特征