吸附无细胞百白破灭活脊髓灰质炎和b型流感嗜血杆菌(结合)联合疫苗基础免疫后脊髓灰质炎中和抗体水平观察  

Observation of neutralizing antibody against poliovirus following primary vaccination of DTaP-IPV/Hib

作　　者：符剑[1] 龚黎明[1] 何寒青[1] 葛琼[1] 李倩[1] 邓璇[1] 唐学雯[1] 严睿[1] 

机构地区：[1]浙江省疾病预防控制中心,浙江杭州310051

出　　处：《中国预防医学杂志》2016年第1期41-45,共5页Chinese Preventive Medicine

基　　金：浙江省医药卫生科技计划项目(2012KYB049)

摘　　要：目的观察吸附无细胞百白破灭活脊髓灰质炎和b型流感嗜血杆菌(结合)联合疫苗(DTaP-IPV/Hib五联疫苗,简称五联苗)基础免疫后的脊髓灰质炎(简称脊灰)中和抗体水平,并与传统的口服脊灰减毒活疫苗(oral poliomyelitis attenuated live vaccine,OPV)免疫效果对比分析。方法选择无脊灰疫苗接种禁忌证的健康婴儿,按照接种疫苗的不同,分为五联苗组和OPV组,每组100人。收集每个研究对象的脐带血和基础免疫后的颈静脉血,以微量中和试验测定血清中脊灰病毒Ⅰ、Ⅱ、Ⅲ型中和抗体。将抗体几何平均滴度(geometric mean titer,GMT)进行对数转换,采用t检验、χ2检验比较免疫前后抗体水平差异。结果基础免疫后,两组Ⅰ、Ⅱ、Ⅲ型脊灰中和抗体水平较免疫前均有显著提高(P<0.01),保护率均达100%。五联苗组基础免疫后Ⅰ、Ⅱ、Ⅲ型脊灰中和抗体GMT分别为227.54、186.11、377.41,OPV组分别为1 217.75、680.29、418.77,两组Ⅰ、Ⅱ型抗体水平差异有统计学意义,五联苗低于OPV组(Ⅰ型:t=-10.80,P<0.01;Ⅱ型:t=-8.941,P=0.010);Ⅲ型抗体水平差异无统计学意义(t=-0.624,P=0.776)。基础免疫后Ⅰ、Ⅱ、Ⅲ型脊灰中和抗体水平与性别、出生体重、母传抗体水平无线性相关关系,Ⅰ、Ⅱ型抗体水平与采血间隔和接种疫苗的种类有线性相关关系。结论五联苗3剂次基础免疫后可提供针对脊灰的有效免疫保护,但Ⅰ、Ⅱ型抗体水平相对于OPV免疫后较低,建议对基础免疫时全程接种五联苗的儿童在4岁加强免疫时口服1剂次OPV。Objective To observe the neutralizing antibody against poliovirus following the primary vaccination of diphtheria,tetanus,pertussis（acellular,component）,poliomyelitis（inactivated）vaccine（adsorbed）and Haemophilus influenza type b conjugate vaccine（DTaP-IPV/Hib）,by comparing with the traditional oral poliomyelitis attenuated live vaccine（OPV）. Methods Healthy infants without vaccination contraindications was assigned to DTaP-IPV/Hib group（n=100）and OPV group（n=100）based on their vaccine choice.The cord blood was collected from each infant,and jugular vein blood samples were collected as well after primary vaccination.The neutralizing antibody titers against poliovirus types 1,2and 3were tested using micro-neutralization method.Student t test and Chi-square test were used for data analysis. Results The seropositive rates of neutralizing antibody against poliovirus type I,II and III were all 100% post primary vaccination.The GMT of neutralizing antibody against poliovirus type I and II were significantly lower in DTaP-IPV/Hib group compared to those in OPV group（227.54 vs 1 217.75,t=-10.80,P0.01;186.11 vs 680.29,t=-8.941,P=0.010）,but not for typeⅢ（377.41 vs 418.77,t=-0.624,P=0.776）.There were no linear correlations of antibody against all three types with gender,birth weight,and maternal anti-polio antibody.However,the levels of neutralizing antibodies of type I and type II were linearly correlated with time interval（between the 3rd vaccination and blood sampling collection）and vaccine type. Conclusions The effective anti-polio protection can be obtained through 3doses primary vaccination of DTaP-IPV/Hib.Due to the lower antibody GMT of type I and II,1dose OPV booster immunization at age 4is recommended to children who receive 3doses of DTaP-IPV/Hib.

关 键 词：脊髓灰质炎 吸附无细胞百白破灭活脊髓灰质炎和b型流感嗜血杆菌(结合)联合疫苗 口服脊髓灰质炎减毒活疫苗 中和抗体 

分 类 号：R186[医药卫生—流行病学]