文章摘要

95例类百日咳综合征患儿的临床特征及淋巴细胞亚群变化

作者: 1吴 碧琛, 1饶 花平, 1方 红军
1 湖南省儿童医院呼吸一科,长沙 410000
通讯: 吴 碧琛 Email: nai96016311@163.com
DOI: 10.3978/j.issn.2095-6959.
基金: 湖南省科技厅临床医疗技术创新引导项目 (2017SK50705)。

摘要

目的:探讨95例类百日咳综合征患儿的临床特征及淋巴细胞亚群变化。方法:回顾性分析 2017年1月至2018年1月湖南省儿童医院呼吸科收治住院的95例类百日咳综合征患儿的临床特征及大环内酯类治疗前后淋巴细胞亚群的变化,并用t检验进行统计学分析。结果:1)共纳入95例类百日咳综合征住院患儿;女46例(48.40%),男49例(51.60%)。其中年龄≤3个月且无百日咳疫苗接种史64例(67.37%);年龄>3个月均有百日咳疫苗接种史31例(32.63%)。2)呼吸道病毒抗原阴性60例(63.16%),呼吸道病毒抗原阳性35例(36.84%);痰培养阴性61例(64.21%),痰培养阳性34例(35.79%);肺炎支原体或衣原体阴性78例(82.10%),阳性17例(17.90%)。3)年龄≤3个月大环内酯类治疗前CD3组均值为50.00,治疗后为56.12,差异有统计学意义(P<0.05);治疗前CD4组均值为24.33,治疗后为28.64,差异有统计学意义(P<0.05);治疗前后CD8,CD4/CD8组均值比较,差异无统计学意义(P>0.05)。年龄>3个月大环内酯类治疗前后CD3,CD4,CD8和CD4/CD8组均值比较差异均无统计学意义(P>0.05)。结论:类百日咳综合征患儿以年龄小于3个月且无百日咳疫苗接种史为多,该部分患儿淋巴细胞亚群在大环内酯类治疗前后存在变化,对这些患儿在临床上尽早予以大环内酯类药物治疗可能有利于疾病恢复。
关键词: 类百日咳综合征;淋巴细胞亚群;大环内酯类

Clinical features and changes of lymphocyte subsets of 95 pediatric patients with pertussis-like syndrome

Authors: 1WU Bichen, 1RAO Huaping, 1FANG Hongjun
1 First Department of Respiratory Medicine, Hunan Children’s Hospital, Changsha 410000, China

CorrespondingAuthor:WU Bichen Email: nai96016311@163.com

Foundation: This work was supported by the Clinical Medical Technology Innovation Guidance Project of Hunan Science and Technology Department, China (2017SK50705).

Abstract

Objective: To explore the clinical features and changes of lymphocyte subsets in 95 pediatric patients with pertussis-like syndrome. Methods: The clinical features and changes of lymphocyte subsets before and after macrolide treatment were retrospectively analyzed among 95 pediatric patients with pertussis-like syndrome who were admitted to the Department of Respiratory Medicine of Hunan Children’ s Hospital from January 2017 to January 2018. The t test was used for statistical analysis. Results: 1) A total of 95 hospitalized pediatric patients with pertussis-like syndrome were enrolled, and there were 46 (48.40%) females and 49 (51.60%) males. Among them, there were 64 cases (67.37%) aged ≤3 months without history of pertussis vaccination, 31 cases (32.63%) aged >3 months with history of pertussis vaccination. 2) There were 60 cases (63.16%) negative for respiratory virus antigen, 35 cases (36.84%) positive for respiratory virus antigen; 61 cases (64.21%) negative and 34 cases (35.79%) positive for sputum culture; 78 cases (82.10%) negative and 17 cases (17.90%) positive for Mycoplasma pneumoniae or Chlamydia pneumoniae. 3) Among patients aged ≤3 months, the average CD3 values were 50.00 and 56.12 before and after macrolide treatment respectively, the difference was statistically significant (P<0.05); for CD4, the average values were 24.33 and 28.64 before and after macrolide treatment respectively with statistically significant difference (P<0.05). No statistically significant differences were found in the average values of CD8 and CD4/CD8 before and after macrolide treatment. Among patients aged >3 months, there were no significant differences in the average values of CD3, CD4, CD8 and CD4/CD8 before and after macrolide treatment. Conclusion: Most pediatric patients with pertussis-like syndrome are aged ≤3 months without history of pertussis vaccination. The lymphocyte subsets in this group have changes before and after macrolide treatment. For these patients, macrolides given as early as possible in clinical practice may be beneficial to disease recovery.
Keywords: pertussis-like syndrome; lymphocyte subsets; macrolides