| Aim:To summarize the clinical characteristics of children with pertussis in hospital from 2014 to 2016 and analyze the risk factors of severe cases,so as to find the risk factors of developing severe cases and protect these children.Methods:A retrospective analysis was made on the clinical data of 165 patients with pertussis in Qilu Children's Hospital of Shandong University from January 1,2014 to December 31,2016.The children were divided into two groups according to the age of children,the children who are younger than 3 months were enrolled in group 1 and all the other children were enrolled in group 2.There were 66 children were enrolled in group 1 and there were 99 cases in group 2.There were 28 severe cases according to the clinical characters and 137 common cases..The clinical data were retrospectively analyzed and compared.Results:The number of patients diagnosed pertussis were 33(20.0%)in 2014,48(29.1%)in 2015,and 84(50.9%)in 2016,respectively.In the total 165 children,66 cases(40.00%)aged from 0 to 3 months,40(24.24%)aged from 3 to 6 months,23(13.94%)aged from 6 months to 1 year,and 36 children(21.82%)aged older than 1 year.(2)Paroxysms of coughing were found in 127 cases(80.0%),48 cases(29.1%)had inspiratory whoop,135cases(81.8%)had flushed faces or cyanosis,73 cases(44.2%)caught a fever,39cases(23.6%)vomited after coughing,5 cases(3.05%)had edema,6 cases(3.6%)had apnoea.Infants in group 1 often had flushed faces or cyanosis(?~2=4.244,P<0.05),and more sever cases tended to appear in this group(P<0.05).At the same time,complications such as encephalopathy and respiratory failure were more common in group 1 than in group 2(P<0.05).Fever,edema and apnoea occurred more frequently in the group made up of severe cases than in the ordinary group(P<0.05),while it had more inspiratory whoop and vomiting after coughing than in the severe case group(P<0.05).(3)Leukocytosis was found in 102 cases(61.8%),132 cases had predominant lymphocytosis.And blood cell in severe case group was higher than in the ordinary one(Z=2.540,P<0.05).(4)There were 65 cases infected with other 29 pathogens except bordetella pertussis,which were consisted of bacteria,fungi,viruses,mycoplasma and chlamydiae.The five most common pathogens were adenovirus(16cases,24.6%),mycoplasma pneumoniae(14 cases,21.5%)and staphylococcus aureus(7 cases,10.8%),parainfluenza virus(6 cases,3.6%),haemophilus influenzae(5 cases,3.0%)and chlamydia pneumoniae(5cases,3.0%).(5)Patients who were not fully immunized by DTP and had pulmonary consolidation or atelectasis on chest imaging were prone to develop into severe cases(OR=20.800?33.345,P<0.05).Conclusions:The incidence of pertussis was growing year after year among children.Most of the patients had a favorable prognosis.Infants younger than 3 months old or unvaccinated with DTP had high susceptibility to pertussis,and often had a severe clinical presentation and long duration of hospitalization.Children who were not vaccinated with DTP in time and had pulmonary consolidation or atelectasis on chest imaging were prone to develop into severe cases. |
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