婴儿麻疹发病的危险因素及其控制策略  

Analysis on Risk Factors of Infants Measles Incidence and Strategies of Measles Control

作　　者：曲江文[1] 高志刚[1] 万丽霞[1] 朱向军[1] 丁亚兴[1] 李永成[1] 陈伟[1] 张之伦[1] 

机构地区：[1]天津市疾病预防控制中心,天津300011

出　　处：《中国疫苗和免疫》2011年第2期152-154,181,共4页Chinese Journal of Vaccines and Immunization

摘　　要：目的探讨婴儿麻疹发病的危险因素,为控制婴儿麻疹发病提供依据。方法采用病例对照研究的方法,探讨医院暴露与婴儿麻疹发病的关系。对<8月龄未患过麻疹的本地常住婴儿,采用酶联免疫吸附试验检测麻疹IgG抗体;对历年法定传染病报告系统和麻疹监测系统的监测数据,以及流行病学调查资料进行分析。结果医院暴露是婴儿患麻疹的重要危险因素(比值比=15.4)。2004～2009年9～11月龄婴儿病例中,72.59%未及时接种首剂麻疹减毒活疫苗(Measles Attenuated Live Vaccine,MV);婴儿麻疹抗体随着月龄增长呈趋势性衰减;7月龄时抗体阳性率、保护性抗体阳性率、抗体几何平均浓度分别为13.64%、4.55%和174.20mIU/ml(毫国际单位/毫升)。婴儿麻疹发病率与全人群的发病率密切相关(相关系数r=0.938,P<0.01)。结论婴儿麻疹发病主要与母传抗体消失过早、MV接种不及时、医院感染、接触传染源的机会等因素有关,控制的关键在于通过降低全人群麻疹发病率来减少婴儿感染麻疹病毒的机会。Objective To explore the risk factors of incidence, and to provide basis for measles control in infants. Methods Case-control study was used to explore the relationship between hospital exposure and measles incidence in infants. Enzyme-Linked Immunosorbent Assay （ELLSA）IgG antibody detection was conducted in local babies aged 〈 8 months who were not infected with measles by the method of ELLSA. Measles surveillance data and survey data were analyzed using epidemiological method. Results Hospital exposure was an important risk factor for infant infection（OR=15.4）, and 72.59% infant cases aged from 9 to 11 months didn＇t vaccinate the first dose of measles vaccine in time from 2004 to 2009. Antibody level in infants showed a attenuation tendency with the increase of age. The seropositive rate, protective seropositive rate and GMC are 13.64%, 4.55% and 174.20mIU/ml respectively. The measles incidence in infants were closely associated with the incidence of whole population. The result of linear correlation analysis indicated that coefficient of correlation was 0.938 （P〈0.01）. Conclusions The measles incidence in infants were associated with many factors, such as early inoculation, to decrease disappearance of maternal antibody, delay vaccine hospital cross infection, opportunity of contacting source of infection. The critical control measure is opportunity of measles infection in infants by decreasing the incidence of whole population.

关 键 词：麻疹 婴儿 危险因素 控制策略 

分 类 号：R511.1[医药卫生—内科学] R186[医药卫生—临床医学]