换血治疗婴儿重症百日咳合并高白细胞血症1例报道

魏雪梅; 杨慧; 雷旻; 邓继岿

doi:10.7499/j.issn.1008-8830.2019.03.005

PDF(1195 KB)

HTML

中国当代儿科杂志 ›› 2019, Vol. 21 ›› Issue (3) : 214-217. DOI: 10.7499/j.issn.1008-8830.2019.03.005

疫苗接种与疾病预防专题

换血治疗婴儿重症百日咳合并高白细胞血症1例报道

魏雪梅¹, 杨慧², 雷旻¹, 邓继岿¹

作者信息 +

Blood exchange transfusion for treatment of severe pertussis in an infant

WEI Xue-Mei¹, YANG Hui², LEI Min¹, et al¹

Author information +

文章历史 +

摘要

百日咳是由百日咳鲍特菌感染引起的急性呼吸道传染病。其典型的临床表现为无热痉挛性咳嗽，大部分预后良好，少部分并发重症肺炎、百日咳脑病、高白细胞血症、肺动脉高压，预后不良，甚至死亡。有研究者认为出现以上严重并发症，需要入住重症监护室（NICU/PICU）治疗的病例即为重症百日咳病例^[1]。目前，对于具有明显高白细胞血症的重症百日咳患儿，较为推荐的降白细胞措施即为换血治疗，但国内相关报道较少。2018年11月上海儿童医学中心首次报道采用换血治疗1例6月龄的重症百日咳女婴，但该患儿在接受换血术前已存在多器官功能衰竭，最终死亡^[2]。我院NICU收治1例30日龄的百日咳男性患儿，合并明显的高白细胞血症，经换血治疗，白细胞明显下降，效果理想，患儿好转出院。结合国内外已有百日咳合并高白细胞血症及换血治疗的相关文献，将本病例报告如下，以期加深儿科医师对换血疗法的认识，为伴发高白细胞血症的重症百日咳患儿的救治提供思路。

Abstract

No abstract available

引用本文

EndNote

Ris (Procite)

Bibtex

导出引用

魏雪梅, 杨慧, 雷旻, 邓继岿. 换血治疗婴儿重症百日咳合并高白细胞血症1例报道[J]. 中国当代儿科杂志. 2019, 21(3): 214-217 https://doi.org/10.7499/j.issn.1008-8830.2019.03.005

WEI Xue-Mei, YANG Hui, LEI Min, et al. Blood exchange transfusion for treatment of severe pertussis in an infant[J]. Chinese Journal of Contemporary Pediatrics. 2019, 21(3): 214-217 https://doi.org/10.7499/j.issn.1008-8830.2019.03.005

参考文献

[1] 徐勇胜. 百日咳临床特征研究进展[J]. 中国实用儿科杂志, 2016, 31(9):712-714.
[2] 项龙, 曹清, 奚悦玲, 等. 白细胞去除术治疗婴儿高白细胞合并肺动脉高压百日咳三例并文献复习[J]. 中国小儿急救医学, 2018, 25(11):801-806.
[3] Berger JT, Carcillo JA, Shanley TP, et al. Critical pertussis illness in children:a multicenter prospective cohort study[J]. Pediatr Crit Care Med, 2013, 14(4):356-365.
[4] 中华人民共和国卫生部. WS 274-2007百日咳诊断标准[EB/OL]. (2007-04-17). http://www.moh.gov.cn/zwgkzt/s9491/201410/52040bc16d3b4eecae56ec28b3358666.shtml.
[5] 姚开虎, 邓继岿, 热夏提·达吾提. 百日咳诊断:现行标准的局限性和GPI建议[J]. 中国当代儿科杂志, 2016, 18(9):891-896.
[6] Winter K, Zipprich J, Harriman K, et al. Risk factors associated with infant deaths from pertussis:a case-control study[J]. Clin Infect Dis, 2015, 61(7):1099-1106.
[7] Grzeszczak MJ, Churchwell KB, Edwards KM, et al. Leukopheresis therapy for severe infantile pertussis with myocardial and pulmonary failure[J]. Pediatr Crit Care Med, 2006, 7(6):580-582.
[8] Rowlands HE, Goldman AP, Harrington K, et al. Impact of rapid leukodepletion on the outcome of severe clinical pertussis in young infants[J]. Pediatrics, 2010, 126(4):e816-e827.
[9] 邓继岿, 王红梅, 田树凤. 儿童百日咳的临床特点及实验室诊断[J]. 中华实用儿科临床杂志, 2017, 32(22):1692-1695.
[10] 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.
[11] Kazantzi MS, Prezerakou A, Kalamitsou SN, et al. Characteristics of Bordetella pertussis infection among infants and children admitted to paediatric intensive care units in Greece:a multicentre, 11-year study[J]. J Paediatr Child Health, 2017, 53(3):257-262.
[12] Paddock CD, Sanden GN, Cherry JD, et al. Pathology and pathogenesis of fatal Bordetella pertussis infection in infants[J]. Clin Infect Dis, 2008, 47(3):328-338.
[13] Assy J, Seguela PE, Guillet E, et al. Severe neonatal pertussis treated by leukodepletion and early extra corporeal membrane oxygenation[J]. Pediatr Infect Dis J, 2015, 34(9):1029-1030.
[14] Sawal M, Cohen M, Irazuzta JE, et al. Fulminant pertussis:a multi-center study with new insights into the clinch-pathological mechanisms[J]. Pediatr Pulmonol, 2009, 44(10):970-980.
[15] Oñoro G, Salido AG, Martinez IM, et al. Leukoreduction in patients with severe pertussis with hyperleukocytosis[J]. Pediatr infect Dis J, 2012, 31(8):873-876.
[16] Kuperman A, Hoffmann Y, Glikman D, et al. Severe pertussis and hyperleukocytosis:is it time to change for exchange?[J]. Transfusion, 2014, 54(6):1630-1633.
[17] 陈世旺. 不同球浆比组分血换血治疗新生儿高胆红素血症的疗效比较[J]. 临床儿科杂志, 2013, 31(12):1143-1146.
[18] Tian SF, Wang HM, Deng JK. Fatal malignant pertussis with hyperleukocytosis in a Chinese infant[J]. Medicine, 2018, 97(17):e0549.
[19] Cherry JD, Wendorf K, Bregman B, et al. An observational study of severe pertussis in 100 infants ≤ 120 days of age[J]. Pediatr Infect Dis J, 2018, 37(3):202-205.