百日咳疫苗接种对婴幼儿百日咳临床表现的影响

唐琦钦, 甘川, 吴小英, 许红梅, 张祯祯

中国当代儿科杂志 ›› 2021, Vol. 23 ›› Issue (2) : 138-142.

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中国当代儿科杂志 ›› 2021, Vol. 23 ›› Issue (2) : 138-142. DOI: 10.7499/j.issn.1008-8830.2008081
论著·临床研究

百日咳疫苗接种对婴幼儿百日咳临床表现的影响

  • 唐琦钦, 甘川, 吴小英, 许红梅, 张祯祯
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Effect of pertussis vaccination on clinical manifestations of infants and young children with pertussis

  • TANG Qi-Qin, GAN Chuan, WU Xiao-Ying, XU Hong-Mei, ZHANG Zhen-Zhen
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摘要

目的 探讨百日咳疫苗接种对婴幼儿百日咳临床表现的影响。方法 回顾性分析不同百日咳疫苗接种状态的百日咳婴幼儿临床表现及外周血细胞水平的差异。结果 共入组1 083例<3岁百日咳患儿,其中未接种组551例,接种组532例;发病年龄<3月龄392例,含未接种372例,接种20例;≥3月龄691例,含未接种179例,接种512例。未接种组住院时间长于接种组(P < 0.05),呼吸衰竭的发生率高于接种组(P < 0.05)。≥3月龄未接种组重症肺炎的发生率高于接种组(P < 0.05);重症肺炎的发生率在0剂次组最高(10.6%), 4剂次组最低(1.2%)。在101例重症肺炎患儿中,未接种组占比79.2%(80例),仅21例(20.8%)发生在4个不同剂次接种组。≥3月龄患儿中,未接种组外周血白细胞计数、淋巴细胞绝对值及血小板计数均高于接种组(P < 0.05)。结论 百日咳疫苗接种可有效降低百日咳患儿重症肺炎、呼吸衰竭等并发症的发生率,减轻呼吸道并发症的严重程度。

Abstract

Objective To study the effect of pertussis vaccination on the clinical manifestations of infants and young children with pertussis. Methods A retrospective analysis was performed to investigate the differences in clinical manifestations and peripheral blood cell levels between pertussis children with different pertussis vaccination status. Results A total of 1 083 children with pertussisat at age of <3 years were enrolled, with 551 children in the unvaccinated group and 532 in the vaccinated group. Of all the children, 392 had an age of onset of < 3 months (372 were unvaccinated and 20 were vaccinated) and 691 children had an age of onset of ≥ 3 months (179 were unvaccinated and 512 were vaccinated). Compared with the vaccinated group, the unvaccinated group had a longer length of hospital stay and a higher incidence rate of respiratory failure (P < 0.05). Among the children ≥ 3 months of age, the incidence of severe pneumonia in the unvaccinated group was higher than that in the vaccinated group (P < 0.05), and the incidence of severe pneumonia was the highest in the unvaccinated group (10.6%) and the lowest in the 4-dose vaccination group (1.2%). Among the 101 patients with severe pneumonia, 80 (79.2%) were observed in the unvaccinated group and only 21 (20.8%) in the four different doses vaccination groups. For the children with an age of onset of ≥ 3 months, the unvaccinated group had higher white blood cell count, absolute value of lymphocytes, and platelet count than the vaccinated group (P < 0.05). Conclusions Pertussis vaccination can reduce the incidence of severe pneumonia and respiratory failure and alleviate the severity of respiratory complications in infants and young children with pertussis.

关键词

百日咳 / 疫苗接种 / 免疫 / 儿童

Key words

Pertussis / Vaccination / Immunization / Child

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导出引用
唐琦钦, 甘川, 吴小英, 许红梅, 张祯祯. 百日咳疫苗接种对婴幼儿百日咳临床表现的影响[J]. 中国当代儿科杂志. 2021, 23(2): 138-142 https://doi.org/10.7499/j.issn.1008-8830.2008081
TANG Qi-Qin, GAN Chuan, WU Xiao-Ying, XU Hong-Mei, ZHANG Zhen-Zhen. Effect of pertussis vaccination on clinical manifestations of infants and young children with pertussis[J]. Chinese Journal of Contemporary Pediatrics. 2021, 23(2): 138-142 https://doi.org/10.7499/j.issn.1008-8830.2008081

参考文献

[1] Di Mattia G, Nicolai A, Frassanito A, et al. Pertussis:new preventive strategies for an old disease[J]. Paediatr Respir Rev, 2019, 29:68-73.
[2] 苏琪茹, 邓继岿. 我国儿童百日咳免疫预防策略[J]. 中华儿科杂志, 2020, 58(7):615-617.
[3] Zerbo O, Bartlett J, Goddard K, et al. Acellular pertussis vaccine effectiveness over time[J]. Pediatrics, 2019, 144(1):e20183466.
[4] 彭晓康, 刘小乖, 李亚绒, 等. 835例百日咳患儿PTIgG水平的影响因素分析[J]. 中国妇幼健康研究, 2020, 31(6):712-716.
[5] Schwartz KL, Kwong JC, Deeks SL, et al. Effectiveness of pertussis vaccination and duration of immunity[J]. CMAJ, 2016, 188(16):E399-E406.
[6] 中华医学会儿科学分会感染学组, 《中华儿科杂志》编辑委员会. 中国儿童百日咳诊断及治疗建议[J]. 中华儿科杂志, 2017, 55(8):568-572.
[7] 江载芳, 申昆玲, 沈颖. 诸福棠实用儿科学[M]. 8版. 北京:人民卫生出版社, 2015:1988-1989.
[8] 庹虎, 唐其柱, 何兵, 等. 儿童肺动脉高压定义和诊断及治疗的研究进展[J]. 实用心脑肺血管病杂志, 2020, 28(7):20-24.
[9] 贾举, 袁林, 高薇, 等. 百日咳并发症[J]. 中国当代儿科杂志, 2019, 21(7):713-717.
[10] Klein NP, Bartlett J, Rowhani-Rahbar A, et al. Waning protection after fifth dose of acellular pertussis vaccine in children[J]. N Engl J Med, 2012, 367(11):1012-1019.
[11] Barlow RS, Reynolds LE, Cieslak PR, et al. Vaccinated children and adolescents with pertussis infections experience reduced illness severity and duration, Oregon, 2010-2012[J]. Clin Infect Dis, 2014, 58(11):1523-1529.
[12] Murray EL, Nieves D, Bradley JS, et al. Characteristics of severe Bordetella pertussis infection among infants ≤ 90 days of age admitted to pediatric intensive care units-Southern California, September 2009-June 2011[J]. J Pediatric Infect Dis Soc, 2013, 2(1):1-6.
[13] Ganeshalingham A, Mcsharry B, Anderson B, et al. Identifying children at risk of malignant Bordetella pertussis infection[J]. Pediatr Crit Care Med, 2017, 18(1):e42-e47.


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