CAJ | 학술논문

目的调查3月龄以下(≤3个月)的住院患儿中迁延性咳嗽(咳嗽2周以上)婴儿博德特百日咳杆菌感染状况.方法对2011年1月至2012年1月首都儿科研究所附属儿童医院收治的3月龄以下迁延性咳嗽患儿采集血清和深部呼吸道分泌物,分别采用酶联免疫吸附实验及多重PCR方法检测博德特百日咳杆菌毒素抗体及博德特百日咳杆菌.结果入组患儿59例,男32例、女27例,均未接种白百破疫苗.多重PCR检测博德特百日咳杆菌阳性患儿17例(28.8％),3例年龄＜1个月,4例1～2个月,10例2～3个月；3例婴儿有家庭内慢性咳嗽患者的密切接触史,其家庭成员百日咳血清抗体阳性.百日咳杆菌阳性患儿中16例有阵发性痉挛性咳嗽,5例有吸气末鸡鸣样吼声,7例有结膜出血,10例有淋巴细胞升高为主的白细胞升高.结论未接种白百破疫苗、博德特百日咳杆菌感染是3月龄以下患儿迁延性咳嗽的重要致病因素；百日咳杆菌多重PCR检测快速、敏感,可用于临床早期诊断；未诊断的成人百日咳可能是婴儿的重要传染源.
목적 조사3월령이하(≤3개월)적주원환인중천연성해수(해수2주이상)영인박덕특백일해간균감염상황.방법 대2011년1월지2012년1월수도인과연구소부속인동의원수치적3월령이하천연성해수환인채집혈청화심부호흡도분비물,분별채용매련면역흡부실험급다중PCR방법검측박덕특백일해간균독소항체급박덕특백일해간균.결과 입조환인59례,남32례、녀27례,균미접충백백파역묘.다중PCR검측박덕특백일해간균양성환인17례(28.8％),3례년령＜1개월,4례1～2개월,10례2～3개월；3례영인유가정내만성해수환자적밀절접촉사,기가정성원백일해혈청항체양성.백일해간균양성환인중16례유진발성경련성해수,5례유흡기말계명양후성,7례유결막출혈,10례유림파세포승고위주적백세포승고.결론 미접충백백파역묘、박덕특백일해간균감염시3월령이하환인천연성해수적중요치병인소；백일해간균다중PCR검측쾌속、민감,가용우림상조기진단；미진단적성인백일해가능시영인적중요전염원.
Objective To explore the prevalence of pertussis in hospitalized infants aged under 3 months with persistent cough.Methods The nasopharyngeal secretions and serum samples were collected from hospitalized infants aged under 3 months with cough for over 2 weeks from January 2011 to January 2012.The samples of nasopharyngeal secretion were suctioned and collected.Multiplex PCR assay was employed to identify Bordetella pertussis( B.pertussis)and enzyme-linked immunosorbent assay used to detect antibody to pertussis toxin (PT-IgG).Total bacterial DNA was exacted from nasopharyngeal secretion and two-target IS481/PT of B.pertussis was detected by PCR.Results Fifty-nine infants (32 boys and 27 girls) were enrolled.None of them was pre-immunized with diphtheria-pertussis-tetanus vaccine.Seventeen infants (28.8％ ) were B.Pertussis positive.Among 17 cases,3 infants under 1 month,4 infants 1 -2months,and 10 infants 2 -3 months.Three infants had household contacts with persistent cough and their serum antibodies to pertussis toxin were positive.Sixteen infants with pertussis had the paroxysms of frequent and rapid coughs while another 5 with pertussis had long inspiratory effort accompanied by a high-pitched "whoop" at the end of paroxysms.Seven infants with pertusis had conjunctiva bleeding,a special sign of pertussis.Ten infants had lymphocytosis with a predominant elevation of lymphocytes.Conclusions B.pertussis is an important pathogen for the infants under 3 months with persistent cough.Multiplex PCR may be used to identify B.pertussis with a high sensitivity.The unrecognized close family members of the infants with pertussis are probably an important source of infection.