眉山市中医医院2024~2025年百日咳流行病学与临床特征分析

Epidemiological and Clinical Characteristics of Pertussis in Traditional Chinese Medicine Hospital of Meishan from 2024 to 2025

摘要: 目的：分析眉山市中医医院百日咳流行病学与临床特征，为临床鉴别诊断和规范治疗提供科学依据。方法：回顾性分析2024年1月至2025年10月眉山市中医医院收治的0~75周岁疑似百日咳感染患者，通过实时荧光定量PCR技术检测百日咳杆菌，运用GraphPad Prism 10.4.2统计学软件分析检测结果，探究百日咳杆菌阳性检出率在不同年龄、发病时间等维度的分布及临床特征。结果：疑似百日咳病例495例，实验室确诊89例，阳性率17.98%，门诊病例占76.40%，住院病例占23.60%，无重症和死亡病例；确诊病例以2024年最多(94.38%)，男性占48.31%、女性占51.69%，确诊高峰期为6~7月(75.28%)，以2~9岁组确诊最多(86.52%)，P < 0.05。不同年龄组百日咳的阳性率整体具有显著差异，其阳性率分别为0~1岁组4.41% (3/68)、2~9岁组20.37% (77/378)、10~18岁组16.67% (6/36)、19~59岁组23.08% (3/13)。百日咳阳性人群阵发性痉挛性咳嗽、肺炎、呕吐、面部潮红、发绀的发生率显著升高(P < 0.001)，而发烧的发生率显著降低(P < 0.001)，在流涕、胸闷胸痛、呼吸困难及病程15天以上的差异无统计学意义。阳性人群WBC、NEU、LYM、PLT计数水平均显著高于阴性组(P < 0.05)，其中WBC的差异最为显著(P < 0.0001)，C反应蛋白(CRP)水平无显著统计学差异。结论：学龄期儿童为百日咳感染的高危人群，且发病具有时间规律性，相关部门需针对高危人群强化百日咳疫苗接种工作，结合发病时间规律开展季节性防控。实时荧光定量PCR技术具有灵敏度高、特异性强、检测耗时短等优势，普及分子检测技术可实现百日咳的快速诊断，以降低发病率。因此，识别百日咳流行病学和临床特征并联合多指标检测有助于在床旁实现早期鉴别诊断，从而制定更具针对性的临床管理方案。

Abstract: Objective: To analyze the epidemiological and clinical characteristics of pertussis in Traditional Chinese Medicine Hospital of Meishan, and to provide a scientific basis for clinical differential diagnosis and standardized treatment. Methods: A retrospective analysis was conducted on suspected pertussis-infected patients aged 0 - 75 years admitted to Traditional Chinese Medicine Hospital of Meishan from January 2024 to October 2025. Bordetella pertussis was detected by real-time fluorescent quantitative PCR, and the results were statistically analyzed using GraphPad Prism 10.4.2 software. The distribution of positive detection rates across different age groups, onset time, and other dimensions, as well as the clinical features, was investigated. Results: Among 495 suspected pertussis cases, 89 were laboratory-confirmed, yielding a positive rate of 17.98%. Outpatient cases accounted for 76.40% and inpatient cases for 23.60%; no severe or fatal cases were observed. The majority of confirmed cases occurred in 2024 (94.38%), with males comprising 48.31% and females 51.69%. The peak incidence occurred from June to July (75.28%), and the 2 - 9 years age group had the highest number of confirmed cases (86.52%) (P < 0.05). The overall positive rate differed significantly among age groups: 4.41% (3/68) in the 0 - 1 year group, 20.37%(77/378) in the 2 - 9 years group, 16.67% (6/36) in the 10 - 18 years group, and 23.08% (3/13) in the 19 - 59 years group. The incidence rates of paroxysmal spasmodic cough, pneumonia, vomiting, facial flushing, and cyanosis were significantly higher in pertussis positive patients (P < 0.001), whereas fever incidence was significantly lower (P < 0.001). No statistically significant differences were found in rhinorrhea, chest tightness and pain, dyspnea, or disease duration exceeding 15 days. The counts of WBC, NEU, LYM, and PLT in the positive group were all significantly higher than those in the negative group (P < 0.05), with WBC showing the most pronounced difference (P < 0.0001); no significant difference was observed in C-reactive protein (CRP) levels. Conclusions: School-age children are at high risk of pertussis infection, and the incidence follows a temporal pattern. Relevant authorities should strengthen pertussis vaccination targeting high-risk populations and implement seasonal prevention and control measures based on the incidence pattern. Real-time fluorescent quantitative PCR offers high sensitivity, strong specificity, and short detection time; popularizing molecular detection technology enables rapid diagnosis of pertussis and reduces morbidity. Therefore, recognizing the epidemiological and clinical characteristics of pertussis combined with multi-index detection facilitates early bedside differential diagnosis, allowing for more targeted clinical management strategies.