Chest:成人和儿童百日咳相关咳嗽的临床特征

2017-05-20 xing.T MedSci原创

成人百日咳或咳嗽后呕吐应考虑百日咳可能的诊断,而缺乏阵发性咳嗽或存在发热的情况下应予以排除。在儿童中,咳嗽后呕吐不能有助于临床诊断试验。

百日咳是一种高传染性的咳嗽原因,显著增加发病率和死亡率。现有的定义包括阵发性咳嗽、百日咳和咳嗽后呕吐,但是其难以诊断。近日,呼吸领域权威杂志chest上发表了一篇研究文章,研究人员旨在确定百日咳相关性咳嗽临床特征的诊断准确性。

研究人员系统地检索了MEDLINE、EMBASE、CINAHL以及SCI-EXPANDED/CPCI-S数据库,检索时间截至2016年6月。比较了经实验室检查证实的百日咳感染阳性和阴性的患者临床特征的研究符合纳入标准。两位研究人员独立完成筛选、数据提取和质量偏差评估。每个特征均用RevMan得出描述性的森林图。研究人员使用二元荟萃分析方法得到合并估计的敏感性和特异性。

研究人员检索了1969篇文献,纳入53篇。对41个临床特征进行了评估诊断的准确性。在成人患者中,阵发性咳嗽、无发热有很高的灵敏度(分别为93.2%,95%可信区间为83.2-97.4,81.8%,95%可信区间为72.2-88.7)和较低的特异性(分别为20.6%,95%可信区间为14.7-28.1,18.8%,95%可信区间为8.1-37.9),而咳嗽后呕吐和咳嗽敏感性较低(分别为32.5%,95%可信区间为24.5-41.6,29.8%,95%可信区间为8.0-45.2),较高的特异性(分别为77.7%,95%可信区间为73.1-81.7,79.5%,95%可信区间为69.4-86.9)。儿童咳嗽后呕吐具有中度敏感性(60%,95%可信区间为40.3-77.0)和特异性(66%,95%可信区间为52.5-77.3)。

成人百日咳或咳嗽后呕吐应考虑百日咳可能的诊断,而缺乏阵发性咳嗽或存在发热的情况下应予以排除。在儿童中,咳嗽后呕吐不能有助于临床诊断试验。

原始出处:

Abigail Moore.et al. Clinical characteristics of pertussis-associated cough in adults and children: a diagnostic systematic review and meta-analysis.chest.2017. http://journal.publications.chestnet.org/article.aspx?articleid=2628643

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15:38:59 CST 2017, time=2017-05-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=200426, encodeId=d120200426dc, content=学习啦谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=43, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3zSn0GqHrsfLK1wzJZRTON4gxYUibhUyOypBwMibC4R7SsppicGhz5Ogoy0VVq4CWnqaD2Moeib8RWxI5lOiaVmnxpan/0, createdBy=c53f1730331, createdName=tanxingdoctor, createdTime=Sat May 20 13:04:41 CST 2017, time=2017-05-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=200399, encodeId=612b2003997b, content=学习一下知识了, beContent=null, objectType=article, channel=null, level=null, likeNumber=58, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160718/IMG578C993D395567540.jpg, createdBy=59b81918946, createdName=flysky120, createdTime=Sat May 20 12:13:20 CST 2017, time=2017-05-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=200365, encodeId=db952003659d, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=53, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmhead/Q3auHgzwzM6P57Bs8gOPaY1cQP9lIia0lmZOEXraGaoicqNToIslXDKw/0, createdBy=7a041951742, createdName=衣带渐宽, createdTime=Sat May 20 09:40:08 CST 2017, time=2017-05-20, status=1, ipAttribution=)]
    2018-01-25 Smile2680
  5. 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  6. 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createdName=flysky120, createdTime=Sat May 20 12:13:20 CST 2017, time=2017-05-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=200365, encodeId=db952003659d, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=53, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmhead/Q3auHgzwzM6P57Bs8gOPaY1cQP9lIia0lmZOEXraGaoicqNToIslXDKw/0, createdBy=7a041951742, createdName=衣带渐宽, createdTime=Sat May 20 09:40:08 CST 2017, time=2017-05-20, status=1, ipAttribution=)]
    2017-05-21 changjiu

    儿童百日咳面红多见

    0

  7. 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15:38:59 CST 2017, time=2017-05-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=200426, encodeId=d120200426dc, content=学习啦谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=43, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3zSn0GqHrsfLK1wzJZRTON4gxYUibhUyOypBwMibC4R7SsppicGhz5Ogoy0VVq4CWnqaD2Moeib8RWxI5lOiaVmnxpan/0, createdBy=c53f1730331, createdName=tanxingdoctor, createdTime=Sat May 20 13:04:41 CST 2017, time=2017-05-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=200399, encodeId=612b2003997b, content=学习一下知识了, beContent=null, objectType=article, channel=null, level=null, likeNumber=58, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160718/IMG578C993D395567540.jpg, createdBy=59b81918946, createdName=flysky120, createdTime=Sat May 20 12:13:20 CST 2017, time=2017-05-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=200365, encodeId=db952003659d, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=53, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmhead/Q3auHgzwzM6P57Bs8gOPaY1cQP9lIia0lmZOEXraGaoicqNToIslXDKw/0, createdBy=7a041951742, createdName=衣带渐宽, createdTime=Sat May 20 09:40:08 CST 2017, time=2017-05-20, status=1, ipAttribution=)]
    2017-05-20 Y—xianghai

    感觉没说清楚?

    0

  8. 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15:38:59 CST 2017, time=2017-05-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=200426, encodeId=d120200426dc, content=学习啦谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=43, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3zSn0GqHrsfLK1wzJZRTON4gxYUibhUyOypBwMibC4R7SsppicGhz5Ogoy0VVq4CWnqaD2Moeib8RWxI5lOiaVmnxpan/0, createdBy=c53f1730331, createdName=tanxingdoctor, createdTime=Sat May 20 13:04:41 CST 2017, time=2017-05-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=200399, encodeId=612b2003997b, content=学习一下知识了, beContent=null, objectType=article, channel=null, level=null, likeNumber=58, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160718/IMG578C993D395567540.jpg, createdBy=59b81918946, 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    2017-05-20 tanxingdoctor

    学习啦谢谢分享

    0

  9. 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createdName=flysky120, createdTime=Sat May 20 12:13:20 CST 2017, time=2017-05-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=200365, encodeId=db952003659d, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=53, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmhead/Q3auHgzwzM6P57Bs8gOPaY1cQP9lIia0lmZOEXraGaoicqNToIslXDKw/0, createdBy=7a041951742, createdName=衣带渐宽, createdTime=Sat May 20 09:40:08 CST 2017, time=2017-05-20, status=1, ipAttribution=)]
    2017-05-20 flysky120

    学习一下知识了

    0

  10. 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