婴儿麻疹发病率升高的原因及其控制策略分析  

Analysis on the cause and preventive strategy for increased measles incidence in infants

作　　者：成骢[1] 赵红[1] 陆培善[2] 周乙华[3] 

机构地区：[1]东南大学附属南京第二医院感染病科,南京市210003 [2]江苏省疾病预防控制中心 [3]南京大学医学院附属鼓楼医院

出　　处：《江苏医药》2011年第11期1298-1301,共4页Jiangsu Medical Journal

基　　金：江苏省医学科研项目(H201039);南京市科技计划项目(200306069);南京市医学科技发展课题(YKK08122)

摘　　要：目的探讨婴幼儿对麻疹易感的原因并提出控制的策略。方法采集本院47例小于12月龄麻疹患儿的咽拭子和患儿及母亲的血清,同时采集13位幼年患过麻疹的育龄妇女血清作为对照。通过细胞培养测定血清中和抗体滴度,使用ELISA诊断试剂定量检测麻疹IgG和IgM抗体。根据抗体检测结果再分组进行统计学分析。结果 (1)47例患儿中,45例(95.7%)麻疹IgG抗体阴性;(2)麻疹IgM(-)组患儿母亲IgG抗体均值为1108 mIU/ml,明显低于对照组的2793 mIU/ml(P<0.05);(3)麻疹IgM(-)组患儿母亲麻疹中和抗体几何平均滴度(GMT)为1∶30,明显低于对照组的1∶182(P<0.05);(4)8例患儿母亲麻疹IgG抗体及中和抗体水平异常升高。结论 1岁以下幼儿患麻疹的主要原因是患儿没能从母体中获得足够的麻疹抗体;育龄妇女在怀孕前加强接种麻疹疫苗,是可行而又有效的提高婴幼儿对麻疹免疫力的方法。Objective To analyze the cause and preventive strategy for increased measles incidence in infants.Methods Forty-seven infants（≤12 months of age） with a clinical diagnosis of measles and their mothers were recruited.Blood samples from their mothers and 13 women who had the histories of clinical measles were collected for detecting the neutralizing antibody levels by cell cultures and meales IgM and IgG antibodies by ELISA.The results were statistically analyzed.Results（1）The measles IgG antibodies were negative in 45（95.7%） ill infants.（2）The average level of the measles IgG antibody in the mothers with negative IgM was significantly lower than that in the comparable women（1108mIU/ml vs.2793mIU/ml）（P0.05）.（3）The GMT of the measles neutralizing antibody titers in the 47 mothers with negative IgM was 1∶30,which was lower than 1∶182 in the comparable women（P0.05）.（4）The positive measles IgM antibody and extremely high levels of measles IgG underwent subclinical infection were seen in 8 mothers of the infants with measles.Conclusion The main reason for the increased susceptibility to measles in infants less than 1 year old is that the infants have not acquired sufficient measles antibody from their mothers.It appears to be logical and more practical to offer an additional measles vaccine in women before pregnancy.

关 键 词：麻疹病毒 麻疹IGG抗体 婴儿 

分 类 号：R511[医药卫生—内科学]