上海市某城区2014-2015年母婴麻疹抗体水平研究  

A Cross-sectional study on dynamic changes of maternal measles antibody in infants in Shanghai during 2014-2015

作　　者：李淑华[1] 汤喜红[1] 王晶晶[1] 宋品娟 田猛[1] 吴洪彦[1] 王梅 LI Shu-hua;TANG Xi-hong;WANG Jing-jing;SONG Pin-juan;TIAN Meng;WU Hong-yan;WANG Mei(Center for Disease Control and Prevention of Jinshan District,Shanghai 201599,China)

机构地区：[1]上海市金山区疾病预防控制中心,上海201599 [2]上海交通大学医学院附属新华医院崇明分院

出　　处：《中国预防医学杂志》2018年第8期593-596,共4页Chinese Preventive Medicine

基　　金：上海市科学技术委员会科研计划项目(17ZR1424500);上海市卫生和计划生育委员会科研课题(201640154);上海市金山区医学重点专科建设项目(JSZK2015B08);上海市崇明县科学技术发展资金项目(CKY2015-06)

摘　　要：目的分析上海市母婴麻疹抗体水平及其影响因素,为控制初免前小儿麻疹发病提供依据。方法采用横断面研究方法,调查上海市某城区422例孕妇和200例新生儿,以及173例<2岁儿童血清麻疹IgG抗体水平,分析低月龄儿童麻疹抗体消长规律及其与母体的相关性。结果新生儿出生时抗体阳性率85.50%(171/200),保护率41.00%(82/200);随着月龄增长,3~7月龄分别锐减到14.29%(5/35)和2.86%(1/35);8~12月龄时首剂次疫苗接种率仅为51.52%(17/33),抗体阳性率75.76%(25/33),保护率达66.67%(22/33);1~2岁时完成二剂次疫苗接种达94.67%(71/75),抗体阳性率92.00%(69/75)、保护率76.00%(57/75);母婴抗体水平高度相关(r=0.893,P<0.01),孕妇抗体水平阳性率86.97%(367/422),保护率36.02%(152/422),免疫史不详达73.22%(309/422)。结论初免前母传抗体消失以及首剂次疫苗及时接种率低可能是导致<1岁儿童麻疹高发的根本原因,应逐步推进育龄妇女的强化免疫工作,加强预防接种管理,提高首剂疫苗接种率。Objective To understand the dynamic change of serum levels of maternal measles antibody in infants in Shanghai during 2014-2015 1982 and to analyze the influencing factors in order to provide evidence for controlling the incidence of measles in infants. Methods A cross-sectional study was conducted among 422 pregnant women,200 newborns and 173 healthy children under 2 years old to explore the dynamic change of serum levels of measles antibody in mothers and babies by measuring the antibody levels using ELISA. Results The antibody positive rate and protective rate in newborns were 85.50%（171/200）and 41.00%（82/200）respectively at birth,which quickly dropped to 14.29%（5/35）and 2.86%（1/35）at age of 3 to 7 months old,and then increased to 75.76%（25/33）and 66.67%（22/33）at the age of 8-12 months old due to the initial vaccination even though the immunization rate was only 51.52%（17/33）.While,the vaccination rate for the second dose was as high as 94.67%（71/75）at the age of 1-2 years old,and the antibody positive rate and antibody protective rate were 92.00%（69/75）and 76.00%（57/75）.The antibody levels of mothers and babies were highly correlated（r=0.893,P〈0.01）.The antibody positive rate and protective rate of pregnant women were 86.97%（367/422）and 36.02%（152/422）,73.22%（309/422）of pregnant women were not clear about their immunization history. Conclusions The fast clearness of maternal antibody along with the low initial vaccination rate contribute to the high incidence of measles in children under 1 year old,therefore,it is highly suggested that immunization should be strengthened for women with child-bearing age and the vaccine coverage rate of the initial dose should be increased among children.

关 键 词：麻疹 母婴配对 抗体水平 阳性率 保护率 免疫史 横断面研究 

分 类 号：R511.1[医药卫生—内科学]