在百日咳病程早期及时启动有效抗菌治疗（包括在发病前进行药物预防）能够阻止疾病进展，是我国当前尚缺乏孕期免疫等措施的情况下，预防婴儿百日咳重症和死亡的重要手段。但对此“早期”却一直缺乏明确统一的以病程时间判断的标准，少见以此“早期”治疗为目标的“早期”诊断策略的研究报告。该文基于百日咳自然病程及有限的临床证据，提出了以病程7 d内为百日咳早期诊断的时间标准，并探讨了促进百日咳早期诊断的策略：提升公众对婴儿百日咳的警惕性以促进早期就诊；提升临床认识促进早期疑诊及检测；重视密切接触者咳嗽史；识别“三联征（无热、鼻炎卡他、咳嗽）”等早期临床特征；注意白细胞计数和/或淋巴细胞比例显著增高等血常规变化；优先使用病原学方法进行诊断或排除诊断；管理部门应组织构建医院与疾病预防控制机构协同的主动监测筛查等机制。该文旨在通过探讨百日咳早期诊断的时间标准与促进策略，以期推动临床相关研究，促进百日咳早期诊断、药物治疗和预防的规范化，尽可能避免婴儿百日咳重症和死亡。

In the early stages of pertussis, timely initiation of effective antibacterial treatment (including prophylactic medication before symptom onset) can halt disease progression. In China, where measures such as maternal immunization are currently lacking, this remains a crucial approach to preventing severe illness and death from infant pertussis. However, a clear and unified time-based standard defining this "early stage" is lacking, and few studies focus on diagnostic strategies targeting early treatment. Based on the natural disease course of pertussis and limited clinical evidence, a time criterion of within 7 days from illness onset is proposed in this article for early diagnosis of pertussis. Strategies to promote early diagnosis are discussed: raising public awareness to encourage early medical consultation for infant pertussis; enhancing clinical recognition to facilitate early suspicion and testing; emphasizing the cough history of close contacts; identifying early clinical features such as the triad of afebrile status, rhinorrhea, and cough; noting significant increases in white blood cell count and/or lymphocyte proportion in routine blood tests; prioritizing etiological methods for diagnosis or exclusion; and urging health authorities to establish coordinated active surveillance and screening mechanisms between hospitals and disease control institutions. This article aims to support clinical research, standardize early diagnosis, antimicrobial treatment, and chemoprophylaxis of pertussis, and ultimately minimize severe cases and deaths in infants.