柳州市城区0-6岁儿童脊髓灰质炎、麻疹抗体水平及影响因素研究

发布时间：2018-01-05 06:13

本文关键词：柳州市城区0-6岁儿童脊髓灰质炎、麻疹抗体水平及影响因素研究　出处：《广西医科大学》2017年硕士论文　论文类型：学位论文

【摘要】：研究目的了解柳州市城区0-6岁健康儿童脊髓灰质炎(以下简称脊灰)及麻疹人群抗体水平,探讨不同脊灰疫苗免疫程序的免疫效果,初步了解脊灰疫苗的免疫持久性,分析我市脊灰与麻疹抗体阳性的影响因素,评价我市免疫规划效果,为柳州市免疫规划工作提供科学依据。研究方法2016年3-7月,选择柳州市5个城区的儿童进行人口学信息及免疫史收集,并采集血样。采用描述流行病学方法对柳州市城区3727名0-6岁儿童的脊灰抗体及麻疹抗体分布特征进行分析。用酶联免疫吸附测定法(Enzyme-linked immunosorbent assay,ELISA)检测血样中的脊髓灰质炎病毒IgG抗体和麻疹病毒IgG抗体。采用χ~2检验、Cochran-Armitage趋势性检验和二分类logistic回归分析方法比较不同特征儿童脊灰抗体和麻疹抗体水平及影响因素。研究结果1、脊灰抗体总阳性率为90.4%(3369/3727)。不同性别(χ~2=0.160,P=0.689)、民族(χ~2=3.070,P=0.215)、疫苗种类(χ~2=5.941,P=0.051),儿童脊灰抗体阳性率差异均无统计学意义;不同城区(χ~2=20.879,P0.001)、年龄组(χ~2=9.202,P=0.010)、母亲文化程度(χ~2=11.652,P=0.003)、居住属性(χ~2=21.887,P0.001)、接种剂次(χ~2=10.382,P=0.001),儿童脊灰抗体阳性率差异有统计学意义;多因素分析显示母亲文化程度、居住属性和免后间隔时间是影响人群抗体阳性的因素;接种3剂次OPV(Z=4.533,P0.001)与接种4剂次IPV(Z=2.537,P=0.006)的儿童脊灰抗体阳性率均随免疫间隔时间的增加而下降。2、麻疹抗体总阳性率为99.0%(3691/3727)。不同性别(χ~2=0.045,P=0.832)、民族(χ~2=0.367,P=0.832)、母亲文化程度(χ~2=0.281,P=0.869),儿童麻疹抗体阳性率差异均无统计学意义;不同城区(χ~2=12.018,P=0.017)、年龄组(χ~2=16.230,P0.001)、居住属性(χ~2=8.251,P=0.004)、接种剂次(χ~2=69.610,P0.001),儿童麻疹抗体阳性率差异有统计学意义;多因素分析显示疫苗剂次和免后间隔时间是影响人群抗体阳性的因素。研究结论1、柳州市区0-6岁儿童中脊灰与麻疹抗体阳性率均维持在较高水平,达到免疫屏障要求,近期发生此类疫情的可能性较低。2、脊灰疫苗加强免疫及麻疹疫苗复种是非常科学和必要的。3、柳州市区免疫规划工作整体比较规范,但应加强重点年龄段儿童、流动儿童监管,加强文化水平较低母亲的宣传工作,并加强对柳南区免疫门诊的督导和培训工作。
[Abstract]:Objective to investigate the antibody levels of poliomyelitis (polio) and measles in healthy children aged 0-6 years in Liuzhou City, and to explore the immune effect of different immunization procedures of polio vaccine. To understand the immune persistence of poliomyelitis vaccine, to analyze the influencing factors of polio and measles antibody positive in our city, and to evaluate the effect of immunization planning in our city. To provide scientific basis for immunization planning in Liuzhou City. Methods from 2016 to July, 5 urban children in Liuzhou City were selected to collect demographic information and immune history. The distribution characteristics of poliomyelitis antibody and measles antibody in 3727 children aged 0-6 years old in Liuzhou City were analyzed by using the method of descriptive epidemiology. The distribution of polio antibody and measles antibody was determined by enzyme-linked immunosorbent assay (Elisa). Enzyme-linked immunosorbent assay. Elisa was used to detect poliovirus IgG antibody and measles virus IgG antibody in blood samples. Cochran-Armitage trend test and two-classification logistic regression analysis were used to compare the polio antibody and measles antibody levels in children with different characteristics and their influencing factors. The total positive rate of poliomyelitis antibody was 90.4 / 3369 / 37270.There were different sex (蠂 ~ 2 / 0.160) and nationality (蠂 ~ (2 / 2) ~ (3.070)). There was no significant difference in the positive rate of poliomyelitis antibody between children and the type of vaccine (蠂 ~ 2 ~ 2 ~ (5.941) P ~ (0.051)). In different urban areas (蠂 ~ 2 + 2n 20.879) P 0.001, age group (蠂 ~ (2) 9.202), mother's education level (蠂 ~ (2) = 11.652). P0. 003, residential property (蠂 2 + 21. 887%, P 0. 001), inoculum times (蠂 2 + 10. 382% P0. 001). There was significant difference in the positive rate of polio antibody in children. Multivariate analysis showed that the educational level of mother, residence attribute and the interval time after immunity were the factors influencing antibody positive in the population. Three doses of IPV(Z=2.537 were inoculated and 4 doses of IPV(Z=2.537 were inoculated. The positive rate of polio antibody in children with P0. 006) decreased by 2. 2 with the increase of immunization interval. The total positive rate of measles antibody was 99.0 / 3691 / 3727%, with different sex (蠂 ~ (2) 0.045) and nationality (蠂 ~ (2 +) ~ (2) ~ (0.367)). There was no significant difference in the positive rate of measles antibody between children and their mothers (蠂 ~ 2 / 0. 281 ~ 0. 281%, P < 0. 869). Different urban areas (蠂 ~ (2 / 2) ~ (12.018) / P ~ (0.017)), age group (蠂 ~ (2 / 2) ~ (16.230)) P _ (0.001), residence property (蠂 ~ (2) ~ (2)) ~ (8.251). The positive rate of measles antibody in children was significantly higher than that in control group (P < 0.05). Multivariate analysis showed that vaccine dosage and time interval after immunization were the factors influencing antibody positive. Conclusion 1. The positive rates of polio and measles antibodies in children aged 0-6 years in Liuzhou urban area were maintained at a high level. To meet the requirements of the immune barrier, the possibility of such an epidemic in the near future is low, polio vaccine immunization and measles vaccine re-inoculation is very scientific and necessary. 3, Liuzhou city immunization planning work as a whole is more standardized. But we should strengthen the supervision of the key age group, the floating children, strengthen the propaganda work of the mothers with lower education level, and strengthen the supervision and training of the immunization clinic in Liunan district.
【学位授予单位】：广西医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R725.1

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