Study On Etiology,Clinical Characteristics,Pulmonary Function And Prognosis Of Pertussis-like Coughing In Children

Objective1. To evaluate the pulmonary function and clinical significance of children with pertussis-like coughing.2. To identify risk factors associated with the prognosis of pertussis-like coughing.Methods95 hospitalized infants with whooping cough and 67 healthy infants with moist respiratory and pulmonary function were collected.The patients were divided into six groups according to different types of pathogens.The data of each group were retrospectively analyzed.We also collected all the case data from medical records including age,gender,vaccination,clinical symptoms,complication,pathogens,WBC count,lymphocyte ratio,application status of macrolide antibiotics,usage status of sulfamethoxazole(SMZ)and usage status of inhaled glucocorticoids(ICS).Logistics regression was used in this study.Results1.18 cases of normal pulmonary function(18.95%),10 cases of restrictive ventilation dysfunction(10.53%),15 cases of mild obstructive ventilation dysfunction(15.79%),30 cases of moderate obstructive ventilation dysfunction(31.58%)and 22 cases of severe obstructive ventilation dysfunction(23.16%).2. The differences in inspiratory ratio(t I/t E),peaking time ratio(t PF%t E)and peaking volume ratio(v PF%v E)between the two groups were statistically significant(P<0.05)except for tidal volume(VT/Kg)(P>0.05).3. The peaking time ratio(t PF%t E)and peaking volume ratio(v PF%v E)in the group of virus infection,tuberculosis infection,mycoplasma infection,other bacterial infection and pathogen unknown group were different from whooping cough(P<0.05),while there was no statistically significant difference in tidal volume(VT/Kg)between groups(P>0.05).The order of t PF%t E and v PF%v E between each group was pertussis group,virus infection group,other bacterial infection group,mycoplum infection group,pathogen unknown group and tuberculosis infection group.Furthermore,the parameters of each group were lower than that of the healthy control group.4. About 70 children were cured within 2 weeks.120 children were cured from 2 weeks to 3 months including cases of initial attack and relapse.Symptoms lasting longer than 3months accounts for 10.8%.Bordetella pertussis(B.pertussis),WBC count>20×10~9/L and lymphocyte ratio>60%were associated with poor prognosis(P<0.05).ConclusionsThe pulmonary function of children with whooping cough are lower than that of healthy infants,and pulmonary function of children with pertussis has the most significant decline.Pulmonary function test can provide evidence for etiological analysis of children with whooping cough.B.pertussis,WBC count and lymphocyte ratio are independent risk factors for poor prognosis.