脊髓灰质炎疫苗2种序贯免疫程序不同免疫剂次免疫效果的评估  

Evaluation of the efficacy of different immunization agents in 2 sequential immunization procedures of polio vaccine

作　　者：李彦坤[1] 陈伟[1] 丁亚兴[1] 骆晓艳[1] 曲江文[1] 孙静[1] 高志刚[1] LI Yan-kun;CHEN Wei;DING Ya-xing;LUO Xiao-yan;QU Jiang-wen;SUN Jing;GAO Zhi-gang(Department of Infectious Disease Control,Tianjin Center for Disease Control and Prevention,Tianjin,300011,China)

机构地区：[1]天津市疾病预防控制中心传染病控制室

出　　处：《职业与健康》2019年第24期3361-3364,3368,共5页Occupation and Health

摘　　要：目的评估脊髓灰质炎疫苗2种序贯程序下不同剂次的免疫效果,为新免疫策略和免疫程序制定提供依据。方法2016-2017年随机抽取天津市适龄接种脊髓灰质炎疫苗的新生儿128人,分A、B、C 3组,A组42人,B组44人,C组42人。A、B 2组接种1剂脊髓灰质炎灭活疫苗(IPV)和2剂脊髓灰质炎减毒活疫苗(OPV)(I-O-O),C组接种3剂IPV(I-I-I)。各组研究对象分别于接种疫苗后不同时间点采血,采用微量中和试验进行抗体检测,并对抗体阳性率和抗体几何平均滴度水平(GMT)进行分析。结果接种1剂次IPV后,A组Ⅰ型、Ⅱ型、Ⅲ型脊髓灰质炎抗体阳转率分别为69.05%(29人)、71.43%(30人)、71.43%(30人)(P>0.05),抗体阳性率分别为97.62%(41人)、95.24%(40人)、80.95%(34人),3型脊髓灰质炎抗体GMT间差异无统计学意义(P>0.05);接种OPV2或IPV2后,除B组Ⅲ型阳性率为97.73%(43人)外,B组Ⅰ型、Ⅱ型及C组各型阳性率均达到100%,仅Ⅱ型脊髓灰质炎抗体GMT在B、C组间(B组357.42,C组172.28)差异有统计学意义(P<0.05);按I-O-O完成全程接种后,A组各型脊髓灰质炎抗体阳性率均为100%,3型脊髓灰质炎抗体GMT分别为1075.05、464.67、786.53(P<0.05)。结论接种1剂次IPV或接种IPV1+OPV2后各型脊髓灰质炎抗体阳性率未全部达到100%,接种2剂次IPV后各型脊髓灰质炎抗体阳性率均可达到100%;I-O-O序贯程序可以诱导研究对象产生保护性抗体,但在降低脊髓灰质炎的发生可能性方面,I-I-O序贯程序优于I-O-O。Objective To evaluate the immunogenicity of different dose in 2 sequential programs of poilovirus vaccines,to provide evidence for the formulation of new immune strategy and immune program.Methods A total of 128 newborns who should receive polio vaccines in Tianjin were randomly selected from 2016-2017,and divided into A group(42 cases),Bgroup(44 cases)and group(42cases).Group A and B received 1 dose IPV and 2 doses OPV(I-O-O).Group C received 3 doses IPV(I-I-I).The 3 groups were drawn blood at different time point after vaccination.Neutralization test was applied for antibody detection,and analyses of antibody positive proportion and GMT was made.Results After 1 dose IPV inoculation,polio antibody positive conversion rates of typeⅠ,ⅡandⅢin group A were 69.05%(29/cases),71.43%(30 cases),71.43%(30 cases),respectively(all P>0.05),and antibody positive rate were 97.62%(41 cases),95.24%(40 cases)and 80.95%(34 cases),respectively.There was no significant difference in GMT of 3 types of polio antibody(P>0.05).After I-O/I-I inoculation,except the positive rate of typeⅢpolio antibody in group B was 97.73%(43 cases),the positive rates of type I,II in group B and 3 types in group C were all 100%.The difference of GMT of type II polio antibody between group B(357.42)and C(172.28)was statistically significant(P<0.05).After I-O-O inoculation,the positive rates of all types of polio antibodies in group A were 100%,and the GMT of 3 types were 1075.05,464.67 and 786.53,respectively(P<0.05).ConclusionInoculating IPV or IPV-OPV cannot improve the all types of polioantibodies rate to 100%,while inoculating IPV-IPV can.I-O-O sequential program can induce enough magnitude antibodies.But considering of reducing the VAPP,I-I-O sequential program was better.

关 键 词：脊髓灰质炎疫苗 序贯程序 抗体 免疫效果 

分 类 号：R181.3[医药卫生—流行病学]