儿童百日咳细菌培养及抗体检测的临床应用

Clinical application of bacterial culture and antibody detection for pertussis in children

目的探讨儿童百日咳细菌培养及抗体检测的临床应用价值。方法选取温州医科大学附属第二医院、育英儿童医院儿童住院部2018年1月至2020年1月诊断为百日咳的262例住院患儿作为研究对象。所有病例均行百日咳细菌培养及抗体检测。根据患儿性别、年龄、病程、有无接种百日咳疫苗进行分组,并比较不同组间百日咳细菌培养和百日咳抗体检测结果。结果发病年龄集中在≤1岁龄,以≤6月龄为主(62.2%)。百日咳细菌培养总阳性率为82.4%,≤6月龄细菌培养的阳性率最高(94.5%),随着发病年龄增长以及病程延长,细菌培养的阳性率逐渐降低,未接种疫苗的患儿阳性率高于已接种疫苗患儿(P<0.001)。百日咳抗体阳性率为23.3%。随着发病年龄增长以及病程延长,抗体阳性率逐渐升高,未接种疫苗的患儿阳性率低于已接种疫苗患儿(P<0.001)。结论6月龄以下的婴儿仍是百日咳高发的年龄组,百日咳细菌培养在病程早期具有良好的病原学诊断价值,ELISA血清抗体检测法在病程晚期更有意义。

Objective To explore the application value of bacterial culture and antibody detection of pertussis in children.Methods A total of 262 children diagnosed with pertussis at the Second Affiliated Hospital and Yuying Children′s Hospital of Wenzhou Medical University from January 2018 to January 2020 were collected as the research objects.Bacterial culture and serum antibody test for pertussis were performed in all cases.According to the gender,age,course of the disease,and whether the children were vaccinated with pertussis vaccine,the patients were divided into different groups and we compared the detection results of different groups.Results The high incidence age of pertussis was less than 1 year old,mainly less than 6 months old(62.2%).The positive rate of bacterial culture was 82.4%,and the highest positive rate was found in the group of≤6 months old(94.5%).The positive rate of bacterial culture decreased with the increase of age and course of disease,and the positive rate of children without pertussis vaccination was higher than children with pertussis vaccination(P<0.001).The positive rate of pertussis antibody test was 23.3%.The positive rate of antibody test increased with the increase of age and course of disease and the positive rate of children without pertussis vaccination was lower than children with pertussis vaccination(P<0.001).Conclusion The high incidence age of pertussis is mainly less than 6 months old.Bacterial culture of pertussis has a good diagnostic value in the early stage of the course,and enzyme linked immunosorbent assay is more helpful in the late stage of the disease.