水痘疫苗接种儿童水痘IgG水平的横断面研究  

Cross-sectional study on varicella vaccination efficacy in children

作　　者：徐敏钢 黄瑾[1] 汤素文[2] 吴益生[1] 敖建军[1] 华瑞珏 吴霞[1] 徐飚[3] 

机构地区：[1]上海市闸北区疾病预防控制中心,上海200072 [2]上海市疾病预防控制中心,上海200336 [3]复旦大学公共卫生学院,上海200032

出　　处：《上海预防医学》2011年第3期97-99,共3页Shanghai Journal of Preventive Medicine

基　　金：上海市闸北区科委2008年重点课题(05)

摘　　要：[目的]观察儿童1剂水痘疫苗(VarV)免疫的持续效果及其影响因素,初探加强免疫方案。[方法]采集≤12岁接种1剂水痘疫苗的健康儿童手指末梢血629份,用定量酶联免疫吸附试验(ELISA)测定水痘IgG水平,同时调查VarV记录和水痘患病史。[结果]儿童水痘IgG浓度值呈偏态分布,P25为40.19 mIU/mL,P50为96.42 mIU/mL,P75为290.82 mIU/mL,抗体对数值为(2.02±0.69)mIU/mL(95%CI:1.97～2.07)。不同接种年限和不同年龄组抗体浓度值差异有统计学意义(F=2.723,P=0.006和F=3.933,P=0.002)。儿童水痘IgG阳性率为69.0%,本地儿童抗体阳性率显著高于外来儿童(χ2=3.934,P=0.047)。抗体阳性率按VarV接种年限呈U形分布,拐点在接种后4年。[结论]水痘疫苗接种后4年IgG浓度值降到低点,易受水痘感染。建议儿童在接种第一剂满3年后,加强1剂VarV免疫以获更有效免疫保护。[Objective] To observe the long term immune effects and its influence factors of 1 dose of Varicella vaccination in children and to explore the strengthening of immunization program. [Methods] A series of 633 children aged from 12 months to 12 years old were recruited into the study in 2008,who had been injected with 1 dose of imported or domestic Varicella vaccine.From them were collected 629 blood samples from their finger tip blood Varicella medical record tested in 4 blood samples.The level of Varicella IgG antibody was tested by ELISA method.Meanwhile,Varicella vaccination record and varicella disease history were also investigated in the study. [Results] Mean antibody positivity rate was 69.0% and those of Shanghai native children were much higher than those of children from other provinces（χ2=3.934,P=0.047）.Children varicella antibody titers showed a skewed distribution,P25 was 40.19 mIU/mL,P50 was 96.42 mIU/mL,P75 was 290.82 mIU/mL.Antibody on the values for Logarithm were 2.02±0.69 mIU/mL（95%CI：1.97-2.07）.Difference in years since vaccination and difference in age groups inoculated on the antibody titer were statistically significant,respectively（F=2.723,P=0.006 and F=3.933,P=0.002）.Four years after vaccination,antibody in age groups was at the lowest point compared to that of the other groups. [Conclusion] Four years after Varicella vaccination,antibody titers in the body dropped to the lowest point,so children were susceptible to Varicella.It is suggested that children should have another 1 dose of VarV four years after the first dose to get more effective immune protection.

关 键 词：水痘 抗体水平 免疫效果 免疫策略 

分 类 号：R186[医药卫生—流行病学]