Study On Children With Spastic Cough Etiology In Tengzhou City

Background:China pertussis epidemiological investigation project for the Chinese center for disease control and prevention in national epidemiological survey project, in shandong province and two points in the investigation of the xinjiang uygur autonomous region, which choose the su centre in shandong province people’s hospital and laiwu center hospital, su in the centre of the city people’s hospital of pediatrics I’m in charge of the clinical information collection work. The project responsible, directly by the centers for disease control and prevention in shandong province by the centers for disease control and prevention in shandong province to provide fresh sheep blood pertussis medium, dedicated personnel by the centers for disease control and prevention in shandong province already training for3months, have been working nearly1year time, DNA polymerase chain reaction (PCR) to check whooping cough, collected by our hospital pharyngeal swab, directly by the centers for disease control and prevention in shandong province detection, pertussis antibody detection with the hospital, the centers for disease control and prevention in shandong province test supervision, epidemic investigation by su centers for disease control and prevention preventive care division.Objective:The purpose of to explore the etiology, spasmodic cough in children for clinical targeted therapy, especially of pertussis epidemiological investigation, provide scientific basis for vaccination to the nation.Methods:For152cases of children with spastic coughing bacteria with sputum culture measurement, check the pertussis on a nasopharyngeal swab and whooping cough DNA PCR method testing (center for disease control and prevention in shandong province to help complete),blood antibody IgM、IgG whooping cough, blood check respiratory virus9(including pneumonia mycoplasma, pneumonia chlamydia, rickettsia, eosinophilic lung legionella, adenovirus, and respiratory syncytial virus, influenza virus, parainfluenza). At the same time, some children check routine blood, hypersensitive c-reactive protein, is a chest, chest CT, children’s lung function, allergen detection, etc. Consider have high reactivity of children with bronchial diastolic test, determination of breath of nitric oxide (NO). Control group of85cases of children with spastic coughing, simultaneously whooping cough, sputum culture and nine respiratory virus detection.Results:43cases of pharyngeal swab pertussis DNA11cases positive pcR method,43cases of pharyngeal swab pertussis cultures were negative,114cases of blood check pertussis IgM antibody32cases (5cases with the method of pcR, pertussis common DNA positive), whooping cough confirmed in38cases, accounting for25%of the total cases. Sputum culture positive in7cases (including acinetobacter baumannii in1case,1example staphylococcus aureus, klebsiella pneumoniae in2cases,1cases of pseudomonas aeruginosa, white candida in2cases), pneumonia mycoplasma positive in7cases, pneumonia chlamydia positive (3cases), adenovirus positive in1case,14cases of whooping cough in less than five months,36.8%of the total number of whooping cough,11cases of more than5years old,28.9of the total number of whooping cough, positive pathogens for56cases, accounting for36.8%of the total cases. Blood leukocytes of20000more than44cases (29%), lymphocyte ratio more than70%of the53cases (35%), chest slice bronchitis signs54cases, accounting for35.5%, there are signs of pneumonia,21cases (13.8%), lung function:FEV1(forced expiratory volume in one second), PEF)(peak expiratory flow velocity is greater than20%,14cases (9.2%), test positive for allergen21cases, accounting for13.8%, breath of nitric oxide (NO), positive for24cases, accounting for15.8%.Conclusions:the spasmodic cough in children still is given priority to with pertussis infection, with fewer than five months and five years of age or older is given priority to, not with vaccine immunization and vaccination antibody disappear in five years,96cases (63.2%) did not detect the pathogenic bacteria, may be related to testing equipment and technology, as well as for other causes of cough in children with related. Other causes of cough in children with including cough variant asthma, cough, upper airway cough syndrome after infection and other diseases.