百日咳样咳嗽婴幼儿的肺功能特点

Characteristics of pulmonary function in infants and young children with pertussis-like coughing

摘要:

目的 探讨不同病原体感染的百日咳样咳嗽患儿的肺功能特点。方法 收集95例百日咳样咳嗽住院婴幼儿病原学及潮气呼吸肺功能检测资料，并与67例健康婴幼儿（正常对照组）潮气呼吸肺功能检测资料比较。百日咳样咳嗽患儿按病原体种类不同分为百日咳组（17例）、病毒感染组（23例）、结核感染组（6例）、支原体感染组（9例）、其他细菌感染组（8例）以及病原体未明组（32例）。结果 95例百日咳样咳嗽患儿中，轻度阻塞性通气功能障碍15例（16%），中度阻塞性通气功能障碍30例（32%），重度阻塞性通气功能障碍22例（23%）。与正常对照组相比，百日咳样咳嗽患儿吸呼比（tI/tE）、达峰时间比（tPF% tE）和达峰容积比（vPF% vE）均显著降低（均P < 0.05）。结核感染组和支原体感染组潮气量均显著低于正常对照组（均P < 0.05）。除结核感染组外，各病原体感染组tPF% tE和vPF% vE显著低于正常对照组（均P < 0.05）。百日咳组tPF% tE和vPF% vE显著低于其他病原体感染组（均P < 0.05）。结论 百日咳样咳嗽患儿肺功能多有异常；百日咳杆菌感染的患儿肺功能损害最重；潮气呼吸肺功能测试可为百日咳样咳嗽患儿病原体分析提供一定的参考依据。

Abstract:

Objective To study the characteristics of pulmonary function in children with pertussis-like coughing caused by different pathogen infections. Methods The data on etiology and tidal breathing pulmonary function were collected from 95 hospitalized infants and young children with pertussis-like coughing. The tidal breathing pulmonary function was compared between these children and 67 healthy children. According to the type of pathogen, the children with pertussis-like coughing were classified to 6 groups: pertussis (n=17), viral infection (n=23), tuberculosis infection (n=6), Mycoplasma infection (n=9), other bacterial infection (n= 8), and unknown pathogen (n=32). Results Among the 95 children with pertussis-like coughing, 15 (16%) had mild obstructive ventilatory dysfunction, 30 (32%) had moderate obstructive ventilatory dysfunction, and 22 (23%) had severe obstructive ventilatory dysfunction. Compared with the normal control group, the children with pertussis-like coughing had significant reductions in inspiratory-to-expiratory time ratio, ratio of time to peak tidal expiratory flow to total expiratory time (tPF%tE), and ratio of volume to peak tidal expiratory flow to total expiratory volume (vPF%vE) (P < 0.05). The tuberculosis infection and Mycoplasma infection groups had a significantly lower tidal volume than the normal control group (P < 0.05). All pathogen infection groups except the tuberculosis infection group had significantly lower tPF%tE and vPF%vE than the normal control group (P < 0.05). The pertussis group had significantly lower tPF%tE and vPF%vE than the other infection groups (P < 0.05). Conclusions Most of children with pertussis-like coughing have abnormal pulmonary functions. The children with Bordetella pertussis infection have the most severe pulmonary function impairment. Tidal breathing pulmonary function test may provide a reference for pathogen analysis of children with pertussis-like coughing.