新生儿百日咳与婴幼儿百日咳临床对比分析

目的：比较分析新生儿百日咳与婴幼儿百日咳的临床资料，探讨新生儿百日咳的临床特点。方法：回顾性分析2013年4月至2019年7月确诊的71例新生儿百日咳与142例婴幼儿百日咳的临床资料。结果：新生儿百日咳中阵发性咳嗽、痉挛样咳嗽、总的咳嗽时间>14 d、咳剧后呕吐、鸡鸣样回声、喘息、异常淋巴细胞、合并病毒感染发生率均低于婴幼儿组，入院前咳嗽时间短于婴幼儿组，咳嗽缓解时间、住院时间长于婴幼儿组；呼吸道感染接触史、呼吸暂停、发绀、三凹征、肺部闻及中细湿罗音、呼吸衰竭、合并肺炎、肺部实变或不张、合并细菌感染、误诊率、需氧率、机械通气率高于婴幼儿组，差异均有统计学有意义。结论：新生儿百日咳较婴幼儿百日咳症状不典型，但临床症状更重，易出现呼吸暂停，更易合并细菌感染，需氧率高，住院时间长，有致死风险。临床工作中应提高对新生儿百日咳的警惕性。

Clinical Characteristics of Neonatal Pertussis: Comparison with Infant Pertussis

Objective: To compare and analyze the clinical data of neonatal pertussis and infant pertussis, and to explore the clinical characteristics of neonatal pertussis. Methods: Clinical data of 71 neonates with pertussis (neonate group) and 142 infants with pertussis (infant group) admitted from Apr. 2013 to Jul. 2019 were retrospectively analyzed. Results: The incidence of paroxysmal cough, spastic cough, total duration of cough >14 d, vomiting after cough, crowing echo, wheezing, abnormal lymphocytes, and complicated virus infection in neonatal pertussis were lower than those in infant pertussis. The duration of cough before admission was shorter than that in infant pertussis, and the disappearance time of cough and length of stay were longer than those in infant pertussis. History of exposure to respiratory tract infection, apnea, cyanosis, three concave signs, pulmonary rales, respiratory failure, complicated with pneumonia, pulmonary consolidation or atelectasis, complicated with bacterial infection, misdiagnosis rate, oxygen requirement rate and mechanical ventilation rate were higher than those of the infant pertussis, and the differences were statistically significant (P<0.05). Conclusion: Neonatal pertussis is less typical than infant pertussis, yet has more severe clinical symptoms, apnea, bacterial infection, higher oxygen requirement rate, longer length of stay, and higher risk of death. Clinicians should be alert for neonatal pertussis.