育龄妇女麻疹疫苗接种的可行性及安全性研究  

Study on the feasibility and safety of measles vaccination in women of childbearing age

作　　者：夏蝉[1] 温正旺[1] 刘琦[1] 董雷[3] 邱海凡[2] 陈益平[1] 

机构地区：[1]温州医科大学附属第二医院儿童感染科,325003 [2]温州医科大学附属第二医院妇产科,325003 [3]温州市疾病预防控制中心免疫规划科

出　　处：《中华传染病杂志》2016年第4期227-231,共5页Chinese Journal of Infectious Diseases

基　　金：温州市科技计划项目（Y20130364）;国家卫生计划生育委员会国家重点临床专科开放课题（20130102）.

摘　　要：目的探讨育龄妇女接种麻疹疫苗的可行性及安全性，并了解其对婴儿胎传麻疹抗体水平的影响。方法2012年1月1日至12月31日纳入600名育龄妇女为研究对象，参照麻疹抗体水平采用区组分层随机化分组。无接种疫苗组在待产住院时ELISA检测麻疹IgG抗体；接种疫苗组在接种麻疹-腮腺炎-风疹联合减毒活疫苗后3个月及待产时EuSA检测麻疹IgG抗体，反转录-PCR检测血中麻疹核蛋白片段基因（MVN）。接种后2年内有368名妇女分娩，其中健康成长至8月龄婴儿357名，无疫苗接种组育龄妇女所生婴儿出生后8个月内有8例确诊患麻疹，最终纳入研究的8月龄婴儿为349名：高抗体无疫苗接种组育龄妇女所产婴儿52名、高抗体疫苗接种组65名、低抗体无疫苗接种组110名和低抗体疫苗接种组122名，检测8月龄婴儿血麻疹IgG抗体。数据采用t检验、单因素方差分析（组内及组间比较采用Newman-Keuls法）及Pearson相关分析。结果待产时高抗体无疫苗接种组麻疹IgG抗体水平低于高抗体疫苗接种组[（268．5±74．9）IU／mL比（578．3±208．1）IU／mL；Q=15．57，P〈0.01]，低抗体无疫苗接种组低于低抗体疫苗接种组[（169．4±42．3）IU／mL比（584．7±195．8）IU／mL；Q=29．54，P〈0.01]。接种后3个月MVN均无阳性条带，待产时高抗体无疫苗接种组有2例、低抗体无疫苗接种组有1例呈阳性条带。婴儿8月龄时麻疹IgG抗体水平，高抗体无疫苗接种组和高抗体疫苗接种组分别为（106．3±36．8）和（291．8±86．5）IU／mL，差异有统计学意义（t=23．33，P〈0．01），低抗体无疫苗接种组和低抗体疫苗接种组分别为（87．1±26．4）和（274．0±72．5）IU／mL，差异有统计学意义（t=33．27，P〈0．01）。各组孕妇待产时麻疹IgG抗体与所生8月龄婴儿麻疹IgG抗体水平呈正相关（r=0．652，P〈0．01）。8例麻疹婴儿均为无疫苗接种Objective To study the feasibility and safety of measles vaccination in women of childbearing age and to understand the influence of measles vaccination on the fetal transmission measles antibody level of the infants. Methods From January 1, 2012 to December 31, 2012, 600 women of childbearing age were included in this study. The measles IgG antibody was detected, then all participants were randomized according to the IgG level. The measles IgG antibody of participants in non-vaccinated group was detected predelivery in hospital by enzyme linked-immunosorbent assay （ELISA）. That of participants in vaccinated group was detected 3 months after vaccination with measles mumps rubella combined vaccine and predelivery by ELISA. And measles nuclear protein fragment gene （measles virus nucleoprotein, MVN） in the blood was detected by reverse transcription polymerase chain reaction （RT-PCR）. A total of 368 participants gave birth within 2 years after vaccination, and 357 infants 8 months after birth were healthy. In non-vaccinated group, 8 infants were diagnosed with measles within 8 months after birth. Finally, 349 8-month infants were enrolled in the study, including 52 whose mothers in high antibody without vaccination group, 65 whose mothers in high antibody with vaccination group, 110 whose mothers in low antibody without vaccination group and 122 whose mothers in low antibody with vaccination group. The measles IgG antibody levels in the blood of all the 8-month infants were detected. Data were analyzed using t test, one-way ANOVA （Newman-Keuls was used for comparison between groups） and Pearson analysis. Results The measles lgG antibody level of expectant women in high antibody without vaccination group was significantly lower compared to that in high antibody with vaccination group （[268.5±74.9] IU/mLvs [578.3±208.1] IU/mL, Q=15.57, P〈0.01）. That in low antibody without vaccination group was also significantly lower than low antibody with vaccination group （[169.4±42.31 IU/mLvs [584.7±1

关 键 词：麻疹 育龄妇女 胎传抗体 疫苗 

分 类 号：R186[医药卫生—流行病学]