湖州地区儿童百日咳抗体水平调查分析

Investigation and analysis of pertussis antibody level in children in Huzhou

目的调查湖州地区儿童百日咳筛查方式、不同性别及年龄抗体水平分布和体征流行性。方法选取2018年1月—2018年12月于湖州市中心医院就诊的156例疑似百日咳患儿作为研究对象,采用ELISA法、PCR检测两组受检人员的血清抗百日咳抗体IgG水平,用ROC曲线分析各项筛查方式效能,并分析不同性别、年龄、接种次数之间的阳性率和抗体水平。结果百日咳患儿主要以咳嗽/咳痰、喘息及咳嗽剧烈呕吐等症状较为常见。经ROC曲线显示,血清检测准确率77.56%(121/156),PCR检测准确率85.26%(133/156),联合检测准确率98.08%(153/156)。在抗体差异中,男性和女性阳性率、抗体水平差异无统计学意义(P>0.05);不同年龄段抗体水平中以8~<10岁最高,以10~14岁最低,差异有统计学意义(P<0.05);不同接种次数的PT-IgG阳性率差异有统计学意义(P<0.05)。而确诊患儿接受相应治疗后,83.40%好转出院,无死亡病例,住院天数(8.45±3.86)d。结论百日咳多发生在8~<10岁阶段,加强相关监测和疫情调查,能够为控制疫情暴发提供科学依据,且注重合理疫苗接种和相关治疗,可控制病情。

Objective Investigate the screening methods of pertussis in children in Hangzhou,the distribution of antibody levels of different genders and ages,and the prevalence of physical signs.Methods 156 children with suspected pertussis who were treated in our hospital from January 2018 to December 2018 were selected as the research objects.The serum anti-pertussis antibody IgG levels of the two groups of subjects were detected by ELISA and PCR,and analyzed by ROC curve The effectiveness of various screening methods,and anal⁃ysis of positive rates and antibody levels among different genders,ages,and vaccination times.Results Children with whooping cough mainly had symptoms such as cough/sputum expectoration,wheezing,severe cough and vomiting.The ROC curve shows that the accuracy of serum detection is 77.56%(121/156),the accuracy of PCR detection is 85.26%(133/156),and the accuracy of combined detection is 98.08%(153/156).Among the differences in antibodies,there is no statistical difference in the positive rate and antibody levels between males and females(P>0.05);among different age groups,the antibody levels are highest in 8-<10 years old,and lowest in 10-14 years old.There are differences in comparison.(P<0.05);There are also significant differences in the PT-IgG positive rate of different vaccina⁃tion times(P<0.05).After the confirmed children received corresponding treatment,83.40%were improved and discharged,and there were no deaths.The hospital stay was(8.45±3.86)days.Conclusion Pertussis usually occurs in the 8-<10 year old stage.Strengthening related surveillance and epidemic investigation can provide a scientific basis for controlling the outbreak,and focusing on reasonable vaccina⁃tion and related treatments can control the disease.