摘要
目的调查咳嗽≥2周成人住院患者血清中百日咳毒素IgG抗体水平,评估成人迁延性及慢性咳嗽患者中百日咳感染情况,为百日咳防控提供依据。方法收集2023年7月—2024年1月宝鸡市人民医院检验科525例成人咳嗽≥2周住院患者的血清样本,采用酶联免疫吸附试验检测百日咳毒素抗体IgG(pertussis toxin IgG,PT-IgG)的浓度。分析不同浓度下病例及出院诊断分布。结果咳嗽≥2周患者血清PT-IgG浓度中位数为16.94 IU/ml,浓度≥62.5 IU/ml和≥100.0 IU/ml的患者分别有88例(16.76%)和36例(6.86%)。PT-IgG≥100.0 IU/ml的患者在<50岁人群中的检出率(13.79%,8/58)高于≥50岁人群(6.00%,28/467)。患者均没有明确的百日咳诊断史。PT-IgG≥62.5 IU/ml的患者与其他患者比较,出院诊断的分布相似,前五位诊断均为呼吸系统疾病;PT-IgG≥62.5 IU/ml和<62.5 IU/ml患者中慢性阻塞性肺疾病(chronic obstructive pulmonary disease,COPD)最常见,检出率分别为46.59%(41/88)和47.37%(207/437)。结论成人咳嗽≥2周住院患者中百日咳现患或近期感染者不少见。成人COPD、肺炎等常见咳嗽性疾病的临床诊治过程中,应当注意鉴别百日咳特异性原因,积极开展实验室检查明确诊断,及时隔离治疗,以阻断百日咳传播。
Objective To investigate the levels of pertussis toxin IgG(PT-IgG)in the serum of adult inpatients with a cough lasting≥2 weeks and to assess the prevalence of pertussis infection among adults with persistent and chronic cough,to provide abasis for prevention and control of pertussis.Methods Serum samples from adults with a cough lasting≥2 weeks,hospitalized in Baoji People's Hospital from July 2023 to January 2024,were analyzed for PT-IgG concentrations using enzyme-linked immunosorbent assay(ELISA).The distribution of cases and disoharge diagnoses at different concentration were analyzed.Results The median serum PT-IgG concentration in patients with cough≥2 weeks was 16.94 IU/ml,and concentrations≥62.5 IU/ml and≥100.0 IU/ml were found in 88(16.76%)and 36(6.86%)patients,respectively.The detection rate of patients with PT-IgG≥100.0 IU/ml was higher in those<50 years of age(13.79%,8/58)than in those≥50 years(6.00%,28/467).None of the patients had a confirmed diagnosis of pertussis.The discharge diagnosis distribution was similar between patients with PTIgG≥62.5 IU/ml and those with lower levels,with respiratory diseases comprising the top five diagnoses.Chronic obstructive pulmonary disease(COPD)was the most frequent diagnosis,appearing in 46.59%(41/88)of patients with PT-IgG≥62.5 IU/ml and 47.37%(207/437)of other patients with PT-IgG<62.5 IU/ml.Conclusions Pertussis infections,either current or recent,are not uncommon among adult inpatients with a cough lasting≥2 weeks.In managing chronic respiratory conditions such as COPD and pneumonia in adults,clinicians should consider pertussis as a differential diagnosis,encourage laboratory testing to clarify the diagnosis and implement timely isolation and treatment to prevent its transmission.
作者
李海英
郭孟杨
王娅娟
孟庆红
贾彦海
李茜
孙敏
姚开虎
LI Haiying;GUO Mengyang;WANG Yajuan;MENG Qinghong;JIA Yanhai;LI Qian;SUN Min;YAO Kaihu(Laboratory Department,Baoji People's Hospital,Baoji,Shaanxi 721000,China;不详)
出处
《中国预防医学杂志》
2025年第1期88-92,共5页
Chinese Preventive Medicine
基金
国家呼吸系统疾病临床医学研究中心呼吸专项(HXZX-202106)。
