肾综合征出血热疫苗免疫后血清学监测  

Serological surveillance on hemorrhagic fever renal syndrome after vaccination

作　　者：龚震宇[1] 翁景清[1] 赵芝雅[1] 陈毓土[2] 祝阿根[2] 傅桂明[1] 方春福[3] 朱智勇[1] 陈恩富[1] 汪垂章 王玮[3] 雷林海[2] 王臻[1] 

机构地区：[1]浙江省疾病预防控制中心,杭州310009 [2]龙游县疾病预防控制中心 [3]衢州市疾病预防控制中心

出　　处：《中华流行病学杂志》2004年第5期400-402,共3页Chinese Journal of Epidemiology

基　　金：国家"九五"医学科技攻关课题资助项目(96-906-13)

摘　　要：目的 监测肾综合征出血热(HFRS)疫苗免疫接种人群血清抗体水平变化并评价疫苗血清学效果。方法 以村为单位,16～60岁健康者(删除既往患HFRS者、外出>9个月及疫苗禁忌症者)为观察对象,按接种和对照各半的原则随机分组,接种组共10 460人,对照组16 159人。采用间接免疫荧光法测特异性IgG荧光抗体,用微量细胞病变中和试验测中和抗体。结果 接种前血清抗体阴性者全程接种后2周荧光抗体阳转率为100.0％(67/67,95％CI:96.3～100.0),中和抗体阳转率为44 4％(8/18,95％CI:22.0～69.0),几何平均滴度分别为72.1和4.6。1年后进行加强免疫,加强免疫前、免疫后2周,免疫后1年、1.5年、2年、3年和5年,荧光抗体阳性率分别为28.6％、83.3％、75.0％、53.1％、22.6％、10.0％、55.0％;中和抗体阳性率分别为14.8％、55.6％、35.0％、31.3％、26.0％、10.0％、50.0％。免疫(感染)增强反应需要进一步研究。结论 HFRS疫苗免疫效果良好,血清抗体持续时间较长。Objective To observe the serological and epidemiological efficacy of hemorrhagic fever renal syndrome (HFRS) vaccine in Zhejiang province. Methods Immunofluorecent antibody assay and Mcro-CPE method were used to test specific IgG antibody and the titer of neutralizing antibody. Results Two weeks after the injection of the third dose, the sero-conversion rates by both immunofluorecent antibody test (IgG) and neutralization test were 100.0%(67/67)(95% CI: 96.3-100.0) and 44. 4% (8/18) (95% CI: 22. 0-69. 0) with geometric mean titers(GMTs) 72. 1 and 4. 6 respectively. The rates of seroconversion of immunofluorescent antibody by immunofluorescence antibody assay (IFA) were 28. 6%, 83. 3%, 75. 0%, 53. 1%,22. 6%, 10. 0% and 55. 0% before reinforcement, two weeks, one year, one year and a half years, two years, three years and five years after reinforcement. The rates of neutralizing antibody seroconversion by the Mcro-CPE method were found as 14. 8%, 55. 6%, 35. 0%, 31. 3%, 26. 0%, 10. 0% and 50. 0% respectively. We found some antibody dependent immunization enhancement phenomenon among the inoculated population, but further observation was needed. Conclusion HFRS vaccine was immunologically effective and the duration of serous antithey last long.

关 键 词：肾综合征出血热 灭活疫苗 免疫 血清学监测 传染病 

分 类 号：R186[医药卫生—流行病学]