咳嗽≥2周成人住院患者百日咳毒素IgG水平横断面调查  

Cross-sectional study of pertussis toxin IgG levels in adult inpatients with a cough lasting≥2 weeks

作　　者：李海英[1] 郭孟杨 王娅娟 孟庆红 贾彦海 李茜 孙敏[1] 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)

机构地区：[1]宝鸡市人民医院检验科,陕西宝鸡721000 [2]国家儿童医学中心首都医科大学附属北京儿童医院北京市儿科研究所感染与微生物研究室国家呼吸系统疾病临床医学研究中心儿科学国家重点学科儿科重大疾病研究教育部重点实验室

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)。

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.

关 键 词：百日咳 毒素 咳嗽 酶联免疫吸附试验 IGG抗体 

分 类 号：R446.6[医药卫生—诊断学]