河南省百日咳血清流行病学研究及感染率评估  

Sero-epidemiological study and infection rate evaluation of pertussis in Henan Province

作　　者：刘倩 豆巧华 张璐 孔江南 郭永豪 丰达星 姬艳芳[2] 王长双[2] 张明瑜[2] 徐瑾 张延炀 Liu Qian;Dou Qiaohua;Zhang Lu;Kong Jiangnan;Guo Yonghao;Feng Daxing;Ji Yanfang;Wang Changshuang;Zhang Mingyu;Xu Jin;Zhang Yanyang(Henan Immunoprophylaxis Key Laboratory of Medical Science,Zhengzhou 450016,China;Immunization Program,Henan Provincial Center for Disease Control and Prevention,Zhengzhou 450016,China)

机构地区：[1]河南省免疫预防医学重点实验室,郑州450016 [2]河南省疾病预防控制中心免疫预防与规划所,郑州450016

出　　处：《中华预防医学杂志》2024年第7期983-991,共9页Chinese Journal of Preventive Medicine

基　　金：河南省医学科技攻关计划联合共建项目(LHGJ20230616)。

摘　　要：目的分析河南省人群百日咳血清流行病学分布特征、影响因素和百日咳感染率。方法于2022—2023年采用横断面调查方法,调查河南省常住人口,采用酶联免疫吸附试验检测血清百日咳毒素IgG(PT-IgG),分析抗体阳性率(≥20 IU/ml)和中位数浓度(MC),以PT-IgG≥40 IU/ml估算百日咳感染率。抗体水平的组间比较采用秩和检验,抗体阳性率、感染率的组间比较采用χ^(2)检验。结果共纳入研究对象4 810名。PT-IgG总阳性率为12.10%,MC为3.04(0.35,10.36)IU/ml。不同地区、年龄组人群PT-IgG阳性率和抗体水平的差异均有统计学意义(地区阳性率:χ^(2)=134.06,P<0.001,MC:H=337.74,P<0.001;年龄组阳性率:χ^(2)=45.27,P<0.001,MC:H=134.49,P<0.001)。完成全程免疫后1年内PT-IgG阳性率(25.26%)和MC(8.01 IU/ml)最高;接种不同类型百日咳疫苗人群PT-IgG阳性率和抗体水平的差异均有统计学意义(阳性率:χ^(2)=12.38,P=0.006,MC:H=17.93,P<0.001),其中全程接种无细胞百白破-灭活脊髓灰质炎-b型流感嗜血杆菌(结合)联合疫苗人群的抗体阳性率(35.71%)和MC(8.88 IU/ml)高于接种其他类型疫苗人群。对≥3岁且采样前1年内无百日咳疫苗免疫史人群进行百日咳自然感染率评估,在疫苗接种率维持在高水平的情况下,人群百日咳估算感染率为5 757.22/10万。3岁(1 940.16/10万)和4岁(1 765.68/10万)人群感染率处于全人群的低位,6岁时达到峰值(12 656.71/10万)。随后感染率虽然持续下降,但仍维持在较高水平,至40~49岁再次出现峰值(8 740.39/10万)。不同年龄组人群百日咳估算感染率的差异有统计学意义(χ^(2)=53.21,P<0.001)。结论河南省人群百日咳PT-IgG整体处于低位水平;百日咳估算感染率远高于报告发病率;建议在6岁时开展百日咳疫苗加强免疫。Objective To analyze the epidemiological distribution characteristics,influencing factors,and infection rates of pertussis in the population of Henan Province.Methods From 2022 to 2023,a cross-sectional survey was conducted to investigate the permanent population in Henan Province.Enzyme-linked immunosorbent assay(ELISA)was used to detect anti-pertussis toxin IgG(PT-IgG),analyze the antibody positivity rate(≥20 IU/ml)and median concentration(MC),and estimate the pertussis infection rate based on PT IgG≥40 IU/ml.The rank sum test was used to compare antibody levels among groups,and theχ^(2) test was used to compare antibody positive rates and infection rates among groups.Results A total of 4810 research subjects were included in this study.The overall positive rate of PT-IgG was 12.10%and MC was 3.04(0.35,10.36)IU/ml.There were significant differences both in positive rates and antibody levels of PT-IgG among different regions or age groups(region positive rate:χ^(2)=134.06,P<0.001,MC:H=337.74,P<0.001;age group positive rate:χ^(2)=45.27,P<0.001,MC:H=134.49,P<0.001).Both the positive rate of PT-IgG(25.26%)and MC(8.01 IU/ml)were the highest within one year after completing a full course of vaccination.There were significant differences in positive rates and antibody levels among people receiving different types of pertussis vaccines(positive rate:χ^(2)=12.38,P=0.006,MC:H=17.93,P<0.001).The antibody positivity rate(35.71%)and MC(8.88 IU/ml)of the people who received cell-free pertussis inactivated poliomyelitis influenza type b(combined)vaccine throughout the course were higher than those who received other types of vaccines.The natural infection rate of pertussis was evaluated for individuals aged≥3 years who had no history of pertussis vaccine immunization within the year prior to sampling.With a high vaccination rate,the estimated infection rate of pertussis in the population was 5757.22/100000.The infection rates in the 3-year-old(1940.16/100000)and 4-year-old(1765.68/100000)populations were at a low le

关 键 词：百日咳 血清流行病学 估算感染率 横断面研究 

分 类 号：R516.6[医药卫生—内科学] R181.3[医药卫生—临床医学]