小月龄婴儿母传麻疹抗体水平动态变化的纵向研究  

Dynamic maternal measles antibody level in infants： a longitudinal study

作　　者：陆龙[1] 曹毅敏[2] 杨琼英[3] 贺睛[4] 董智强[5] 狄飚[2] 傅传喜[6] 王鸣[7] 

机构地区：[1]广州市荔湾区疾病预防控制中心主任室,510176 [2]广州市疾病预防控制中心病毒免疫部,510440 [3]广州市疾病预防控制中心艾滋病预防控制部,510440 [4]广州市疾病预防控制中心免疫规划部,510440 [5]广州市疾病预防控制中心业务管理部,510440 [6]广州市疾病预防控制中心基层公共卫生部,510440 [7]广州市疾病预防控制中心主任室,510440

出　　处：《中华流行病学杂志》2016年第5期663-667,共5页Chinese Journal of Epidemiology

摘　　要：目的研究小月龄婴儿母传麻疹抗体水平的动态变化，探讨减少其感染麻疹病毒的免疫策略。方法采集2013年7月至2014年4月在广州市某妇幼保健院分娩的母亲及其新生儿出生时（0）、3、5和7月龄血清，采用ELISA检测麻疹IgG抗体，分析母传麻疹抗体水平。结果共纳入689名母亲及691名新生儿（其中双胞胎2对）。母亲血清麻疹抗体浓度和抗体阳性率分别为513．8mIU／ml和81．6％，新生儿分别为732．8mIU／ml和87．3％。新生儿血清麻疹抗体水平与其母亲的血清麻疹抗体水平呈正相关（r=0．9175，P〈0．001）。婴儿自出生后体内的麻疹抗体水平在3月龄时迅速下降，至7月龄时基本转为阴性。低、中抗体水平组婴儿在3月龄时抗体水平均已转为阴性，而高抗体水平组的婴儿在5月龄时抗体水平仍为阳性。结论不同免疫状态母亲的婴儿其母传麻疹抗体水平在8月龄前已基本无法保护婴儿免于感染麻疹，建议适当调整婴儿麻疹疫苗初免月龄，并提高育龄期妇女麻疹抗体水平，以减少小月龄婴儿麻疹发病。Objective To understand the dynamic maternal measles antibody level in infants in Guangzhou. Method Women who delivered babies in a maternal and child health care hospital in Guangzhou and their infants who were never affected by measles were included in our study. All the serum samples collected from mothers and infants were tested by using enzyme linked immunosorbent assay （ELISA） for the quantitative measurement of measles IgG antibodies. A longitudinal sero- epidemiological study was conducted to investigate the duration of the presence of measles maternal antibodies in infants based on the measurement at different time points （0, 3, 5, 7 month）. Result A total of 689 mothers and their 691 infants （two pairs of twins） were included in the study. The concentration and the sero-positivity rate of measles antibody in mothers was 513.8 mIU/ml and 81.6% respectively. The concentration and the sero-positivity rate of measles antibody in infants was 732.8 mIU/ml and 87.3%, respectively. The measles antibody levels of newborns were positively associated with those of mothers （r：0.917 5, P〈0.001）, which declined rapidly at 3 months after birth and mostly turned to be negative at 7 months after birth. Measles antibody turned be negative at 3 months after birth in low, middle level groups, but remained to be positive in high level group at 5 months after birth. Conclusion The maternal measles antibody could rarely protect infants at age of 8 months even though mother had been vaccinated or acquired natural immunity. It is suggested to adjust the time of the first dose measles vaccination in infants and increase the measles antibody level of child bearing aged women to reduce the incidence of measles in infants.

关 键 词：麻疹 母传抗体 婴儿 

分 类 号：R511.1[医药卫生—内科学]