陕西省报告百日咳确诊病例分析  

Analysis of confirmed cases of pertussis reported in Shaanxi Province

作　　者：王锐泽 郑骁 李蔚璇 周天天 吕亚可 胡伟军[1] Wang Ruize;Zheng Xiao;Li Weixuan;Zhou Tiantian;Lyu Yake;Hu Weijun(Immunization Program Institute of Shaanxi Provincial Center for Disease Control and Prevention,Xi′an 710054,China;Administrative Office of Shaanxi Provincial Institute for Tuberculosis Control and Prevention,Xi′an 710048,China)

机构地区：[1]陕西省疾病预防控制中心免疫规划所,西安710054 [2]陕西省结核病防治研究所办公室,西安710048

出　　处：《中华微生物学和免疫学杂志》2024年第6期485-488,共4页Chinese Journal of Microbiology and Immunology

摘　　要：目的了解陕西省百日咳实验室诊断及确诊病例报告现状,评估确诊病例报告质量。方法通过中国疾病预防控制信息系统收集2022年1—7月陕西省报告百日咳确诊病例信息,调查确诊病例的实验室诊断方法和含百日咳成分疫苗免疫史,采用描述性流行病学方法进行统计描述。结果2022年1—7月报告164例百日咳确诊病例中,2例未开展实验室检测,162例完成实验室检测,不同检测方法占比为:分离培养1.85%(3/162)、血清抗体IgG 31.48%(51/162)、血清抗体IgM 14.20%(23/162)、PCR 49.38%(80/162)和血清抗体IgM+PCR 3.09%(5/162)。79例血清学检测阳性病例中,无含百日咳成分疫苗免疫史、接种疫苗至检测时间间隔为<1年、1~3年和>3年的病例分别为12例(15.19%)、15例(18.99%)、11例(13.92%)和41例(51.90%)。综合实验室检测方法和疫苗免疫史分析,164例病例中,误诊/误报38例,误诊/误报率为23.17%。其中0~2岁、3~6岁和≥7岁误诊/误报数分别为17例、12例和9例,误诊/误报率分别为27.42%(17/62)、26.67%(12/45)和15.79%(9/57)。结论陕西省部分医疗机构百日咳实验室检测方法选择不正确,导致一定比例的误诊/误报,需进一步加强培训和规范。Objective To investigate the current status of pertussis laboratory diagnosis and confirmed pertussis cases reporting in Shaanxi Province,and evaluate the quality of case reports.Methods The information of confirmed pertussis cases reported in Shaanxi Province from January to July 2022 was collected through the China Disease Control and Prevention Information System.The laboratory diagnostic methods and pertussis vaccine immunization history of confirmed cases were investigated,and the descriptive epidemiological method was used for statistical description.Results Of the 164 confirmed cases of pertussis reported from January to July 2022,two were not tested in the laboratory and 162 were tested in the laboratory.The proportions of different detection methods were 1.85%(3/162)of isolation and culture,31.48%(51/162)of serum antibody IgG,14.20%(23/162)of serum antibody IgM,49.38%(80/162)of serum antibody PCR and 3.09%(5/162)of serum antibody IgM+PCR.Among the 79 serological positive cases,12 cases(15.19%)had no history of pertussis immunization,and 15 cases(18.99%),11 cases(13.92%)and 41 cases(51.90%)had the time interval from vaccination to detection of<1 year,1-3 years and>3 years,respectively.Based on the analysis of laboratory testing methods and vaccination history,38 cases were misdiagnosed/misreported among 164 cases,with a misdiagnosis or misreported rate of 23.17%.There were 17,12 and 9 cases of misdiagnosis/misreport in 0-2 years old group,3-6 years old group and≥7 years old group,and the misdiagnosis or misreported rates were 27.42%(17/62),26.67%(12/45)and 15.79%(9/57),respectively.Conclusions The selection of pertussis laboratory testing methods in some medical institutions in Shaanxi Province is incorrect,which leads to a certain proportion of misdiagnosis or misreport,and it is necessary to further strengthen the training and standardization.

关 键 词：百日咳 确诊病例 误诊 误报 

分 类 号：R516.6[医药卫生—内科学]