【摘要】 目的 了解浙江省义乌市百日咳病例的流行病学特征，为百日咳诊断与防治提供依据。方法 选择2020年11月1日—2022年8月31日义乌市医疗机构确诊的186例百日咳病例，通过问卷调查收集人口学资料、临床症状和百白破疫苗接种史等资料。分析发病时间、地区、人群、临床症状分布特征，并比较疫苗接种史不同病例的临床特征。结果186例百日咳病例发病时间主要在7—11月，101例占54.30%；发病地区前三位为江东街道、北苑街道和稠江街道，87例占46.77%。男性105例，占56.45%；女性81例，占43.55%。发病年龄≤7岁144例，占77.42%，以托幼儿童和散居儿童为主。临床症状以痉挛性咳嗽、咳嗽后呕吐和夜间咳嗽加重为主，分别占97、82和77例，占52.15%、44.09%和41.40%；血细胞检测显示白细胞计数异常、淋巴细胞计数异常、中性粒细胞计数异常、血小板计数异常和血红蛋白浓度异常分别119、137、39、21和111例，占63.98%、73.66%、20.97%、11.29%和59.68%。未接种、未全程接种、全程接种百白破疫苗分别55、23和108例，占29.57%、12.37%和58.06%；疫苗接种史不同的病例年龄、咳嗽后呕吐、血小板计数异常和血红蛋白浓度异常比例差异有统计学意义（均P<0.05）。结论 2020年11月1日—2022年8月31日义乌市确诊的百日咳病例主要为托幼儿童和散居儿童，临床症状以痉挛性咳嗽、咳嗽后呕吐和夜间咳嗽加重为主，症状并不典型；建议医疗机构提高百日咳鉴别诊断能力。更多还原

【Abstract】 Objective To investigate the epidemiological and clinical characteristics of cases with pertussis in Yiwu City, Zhejiang Province, so as to provide insights into pertussis diagnosis and control. Methods A total of 186 patients with definitive diagnosis of pertussis in medical institutions in Yiwu City from November 1, 2020 to August 31, 2022were recruited, and subjects’ demographic, clinical symptoms and history of pertussis vaccination were collected using questionnaire surveys. The temporal, population, and spatial distribution and clinical symptoms of pertussis were analyzed using a descriptive epidemiological method, and the clinical characteristics of pertussis patients with different doses of pertussis vaccination were compared. Results Pertussis was found to predominantly occur during the period between July and November(101 cases, 54.30%), and the three highest-incidence regions included Jiangdong Street, Beiyuan Street and Choujiang Street(87 cases, 46.77%). The 186 pertussis cases included 105 males(56.45%) and 81 females(43.55%), and included 144 cases with age of onset under 7 year(77.42%). Preschool and diaspora children were predominant among all pertussis cases, and the main clinical symptoms included spasmodic cough(97 cases,52.15%), post-tussive vomiting(82 cases, 44.09%) and aggravated cough at night(77 cases, 41.40%). Routine blood tests measured 119 cases with abnormal white blood cell counts(63.98%), 137 cases with abnormal lymphocyte counts(73.66%), 39 cases with abnormal neutrophil counts(20.97%), 21 cases with abnormal platelet counts(11.29%) and111 cases with abnormal hemoglobin concentrations(59.68%). There were 55 cases that were unvaccinated(29.57%), 23cases that were not fully vaccinated(12.37%), and 108 cases that were fully vaccinated(58.06%). There were significant differences among pertussis cases with different doses of vaccination in terms of age, incidence of post-tussive vomiting, percentage of abnormal platelet counts and percentage of hemoglobin concentrations(all P<0.05). Conclusions The majority of pertussis cases are preschool and diaspora children in Yiwu City from November 1, 2020 to August 31,2022, and the clinical symptoms mainly include spasmodic cough, post-tussive vomiting and aggravated cough at night,with atypical symptoms. The capability for differential diagnosis of pertussis is required to be improved in medical institutions.更多还原