婴儿接种首剂三价口服脊髓灰质炎疫苗后疫苗病毒排毒状况观察  

Observation on Polio Vaccine Virus Excretion in Immunized Infants Given First Dose Trivalent Oral Polio Vaccine

作　　者：陈丽娟[1] 张合润[1] 和京果[1] 王玉梅[1] 陈萌[1] 毕桂英[2] 彭丽燕 

机构地区：[1]北京市疾病预防控制中心,北京100013 [2]北京市东城区和平里医院,北京100013

出　　处：《中国计划免疫》2001年第4期187-190,共4页Chinese Journal of Vaccines and Immunization

基　　金：北京市卫生局预防医学基金资助项目

摘　　要：为了观察婴儿接种首剂三价口服脊髓灰质炎 (脊灰 )疫苗 (TOPV)后疫苗病毒排毒状况 ,采用Hep 2、RD、L2 0B三种细胞 ,对接种首剂TOPV的健康婴儿粪便标本进行了初步调查。结果显示 :脊灰疫苗病毒在人体内具有较好的增殖能力 ,83 9%的婴儿粪便排毒≥ 4周。随时间延长 ,混合多型别向单型别转移 ,但Ⅰ、Ⅱ、Ⅲ型脊灰疫苗病毒均无明显型别优势。采用两种细胞联合检测脊灰疫苗病毒优于一种细胞单独检测 ;而RD +L2 0B细胞联合又优于Hep 2 +RD细胞和Hep 2 +L2 0B细胞。北京市疫苗相关麻痹型脊灰 (VAPP)服苗病例脊灰疫苗病毒检出率主要受使用细胞种类、采集粪便标本时间等多因素影响 ,预计正常情况检出率应≥ 90 % ;分离株以Ⅲ型脊灰疫苗病毒为主 ,则可能是Ⅲ型脊灰疫苗病毒的固有性质所决定 ;要巩固无脊灰成果 ,必须坚持使每个新出生儿童完成全程免疫和对流动儿童实行适时的强化免疫。从健康婴儿分离的Ⅲ型脊灰疫苗病毒 ,多数为疫苗型间基因重组株且具多样性 ,这是否会影响VAPP发生率或带来其它负面影响正在进一步研究中。For observing the vaccine virus excretion after first dose immunization of trivalent oral polio vaccine(TOPV)in infants,we adopted Hep 2,RD and L20B cell lines to isolate the vaccine virus from those infants of healthy state The results showed that the polio vaccine virus had better replicating ability in human intestine proved by its excretion period of ≥4 weeks in 83 9% of the infants Along with the time passing,the mixed types of vaccine virus changed to single type but no dominance of each type,Ⅰ or Ⅱ or Ⅲ,was seen Detection of vaccine virus by combination of two cell lines was superior to single cell line,especially the combination of RD and L20B cells In Beijing,the detection rate of vaccine associated paralytic poliomyelitis(VAPP)cases chiefly depended on cell line used and the time of fecal samples collected Under normal condition,the VAPP detection rate was ≥90% Most isolated vaccine viruses were type Ⅲ which might relate to the inherent property of type Ⅲ vaccine strain For consolidating the polio free achievements,it is necessary to conduct full course immunization continuelly for each infant and supplementary immunization for floating children timely Since polio viruses type Ⅲ isolated were mostly intertypic recombinant polio viruses,whether this may affect the incidence of VAPP or bring about some negative effects are under study

关 键 词：三价口服脊髓灰质炎疫苗 脊髓灰质炎疫苗病毒 细胞 婴儿 TOPV 脊髓灰质炎 

分 类 号：R186[医药卫生—流行病学] R512.4[医药卫生—公共卫生与预防医学]