银川地区持续性咳嗽儿童百日咳博德特菌感染临床调查

摘要

Objective To understand current situation of Bordetella pertussis infection in children with persistent cough and analyze its clinical characteristics. Methods A total of 292 healthy children (≥2 years old) were randomly selected from Yinchuan area as the healthy group, and 157 children (≥6 years old) with persistent cough suspected of BordetelIa pertussis infection were assigned to patient group. Specific toxin antibody ofBordetella pertussis (FI'IgG) was detected by ELISA. Nasopha-ryngeal swabs specimens from ail subjects of patient group were examined by multiplex PCR and bacterial culture. Results The Bordetella pertussis infection rate was 2.6% (4/157) in patient group, 1.6% (1/63) in 6 - 8 years old, 2.8% (1/36) in 8 - 10 years old, 2.5% (1/34) in 10 - 12 years old and 4.2% (1/24) in 12-14 years old. There was a significant difference between each ages. In healthy group, PT TgG level was 1.3 FDA-U/ml. The PT TgG level was 2.5 FDA-U/ml in 2 - A years old, significantly higher than other ages (H=25.6, i'O.Ol). in 12-14 years old, the percentage of the children whose PT IgG level over 30 FDA-U/ml was 12.5%. There were no significant differences among deifferent ages f/'=6.66, P>0.05). Conclusions Bordetella pertussis infection is still one of the causes of children's persistent cough in Yinchuan area. It is necessary to encourage the pertussis vaccination because oflow levels or protective serum antibody in healthy children.%目的 了解银川地区持续性咳嗽儿童百日咳博德特菌感染现状及感染患儿的临床特点.方法随机选取银川地区≥2岁健康儿童292例为正常对照组,选择同期年龄≥6岁持续性咳嗽儿童157例作为可疑百日咳组,应用ELISA法测定两组儿童血清特异性百日咳博德特菌毒素IgG抗体(PT IgG),可疑百日咳组患儿留取鼻咽拭子进行百日咳博德特菌多重PCR检测及分离培养.结果在可疑百日咳患儿中百日咳博德特菌感染率为2.6%(4/157),其中6～8岁组为1.6%(1/63),～10岁组2.8%(1/36),～12岁组2.5%(1/34),～14岁组4.2%(1/24),各组间差异有统计学意义(χ2=363.7,P<0.05).正常对照组儿童血清PT IgG平均几何浓度(GMC)为1.3 FDA-U/ml,其中2～4岁组为2.5 FDA-U/ml,高于其他年龄组(H=25.6,P<0.01),～14岁正常对照组儿童中PT IgG>30 FDA-U/ml者占12.5%,和其他年龄组相比差异无统计学意义(χ2=6.66,P>0.05).结论百日咳博德特菌感染仍是银川地区持续性咳嗽儿童病因之一.由于本地区健康儿童中百日咳保护性抗体水平较低,有必要增加百日咳疫苗预防接种.