| 宣一帆,李林科,赵雪梅,等.儿童百日咳发生的危险因素及外周血细胞分析的预测价值研究[J].安徽医药,2025,29(8):1639-1643. |
| 儿童百日咳发生的危险因素及外周血细胞分析的预测价值研究 |
| Study on risk factors and predictive value of peripheral blood cell analysis for pertussis in children |
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| DOI：10.3969/j.issn.1009-6469.2025.08.031 |
| 中文关键词: 百日咳 儿童 中性粒细胞 淋巴细胞计数 血小板计数 危险因素 预测价值 复合炎症指标 |
| 英文关键词: Pertussis Child Neutrophil Lymphocyte count Platelet count Risk factors Predictive value Compound in-flammatory index |
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| 中文摘要: |
| 目的分析儿童百日咳病例的临床特征及外周血细胞计数，探讨影响儿童百日咳发生的危险因素及外周血细胞分析的预测价值。方法回顾性收集 2019年 1月至 2022年 12月在山西白求恩医院儿科就诊的 244例以“阵发性咳嗽”为主要临床症状的急性咳嗽及迁延性咳嗽病人，按照是否存在百日咳感染分为百日咳组 52例及非百日咳组 192例，对两组临床特征及外周血细胞计数进行分析。结果百日咳组与非百日咳组在中性粒细胞百分比［65.60(51.05，76.15)%比 37.10(21.38，50.55)%］、淋巴细胞百分比［27.05(16.33，39.38)%比 49.95(37.38，66.48)%］、血小板计数、中性粒细胞与淋巴细胞比值( NLR)［0.380(0.223，0.768)比 1.391(0.712，3.008)］、血小板与淋巴细胞比值( PLR)［48.725(38.445，78.465)比 163.349(114.209，274.455)］方面比较均差异有统计学意义(P<0.05)。多因素分析显示，提示百日咳的独立危险因素包括咳嗽病人接触史、痉挛性咳嗽、面红唇绀、合并肺炎、未接种或未完全接种疫苗、淋巴细胞百分比。利用淋巴细胞百分比建立受试者操作特征曲线( ROC曲线)，曲线下面积为 0.84，以最佳截断值 50.80%预测百日咳的灵敏度为 76.90%，特异度为 75.50%。结论在对急性及迁延性咳嗽病儿进行诊治时，有接触咳嗽病人、未接种疫苗，临床症状以痉挛性咳嗽、面红唇绀为主，高淋巴细胞百分比提示存在百日咳感染，百日咳病儿易合并肺炎。淋巴细胞百分比对百日咳感染有一定的预测价值， NLR、PLR有一定的鉴别诊断价值。 |
| 英文摘要: |
| Objective To analyze the clinical characteristics and peripheral blood cell counts of childhood pertussis cases and inves-tigate the risk factors for pertussis development and the predictive value of peripheral blood cell analysis.Methods We retrospective-ly collected 244 cases of acute and prolonged cough with "paroxysmal cough" as the primary symptom from the Department of Pediat-rics at Shanxi Bethune Hospital between January 2019 and December 2022. Cases were classified into a pertussis group (52 cases) anda non-pertussis group (192 cases). Clinical characteristics and peripheral blood cell counts were compared.Results Compared to the non-pertussis group, the pertussis group showed statistically significant differences in neutrophil percentage [65.60 (51.05, 76.15)% vs. 37.10 (21.38, 50.55)%], lymphocytes percentage [(27.05 (16.33, 39.38)% vs. 49.95 (37.38, 66.48)%], platelet count, neutrophil-to-lym-phocyte ratio (NLR) [0.380 (0.223, 0.768) vs. 1.391 (0.712, 3.008)], and platelet-to-lymphocyte ratio (PLR) [48.725 (38.445, 78.465) vs. 163.349 (114.209, 274.455)] (all P< 0.05). Multivariate analysis identified independent risk factors for pertussis, including exposure tocoughing individuals, spasmodic cough, facial redness and cyanosis, coexisting pneumonia, incomplete or absent vaccination, and lym-phocyte percentage. A receiver operating characteristic curve (ROC) for lymphocyte percentage yielded an area under the curve of 0.84.At an optimal cutoff of 50.80%, sensitivity for predicting pertussis was 76.90%, and specificity was 75.50%.Conclusions When diag-nosing and treating children with acute and persistent cough, there may be contact with cough patients who have not been vaccinated,and the clinical symptoms are mainly spasmodic cough and red lips and cyanosis, and elevated lymphocyte percentage may suggest per-tussis, which often complicates with pneumonia. Lymphocyte percentage demonstrates predictive value for pertussis, while NLR andPLR aid differential diagnosis. |
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