我国六个县0~15岁人群肠道病毒71型和柯萨奇病毒A组16型中和抗体水平研究
发布时间：2019-06-22 16:16
【摘要】：目的通过对六个县0-15岁人群肠道病毒71型(Enterovirus Type71, EV71)和柯萨奇病毒A组16型(Coxsakievirus Group A Type16, CVA16)中和抗体(Neutralizing Antibody, NA)水平的调查,了解该人群的EV71和CVA16NA水平分布特征：通过母婴配对的EV71和CVA16NA水平调查,了解母婴EV71和CVA16NA水平分布特征;为制定EV71灭活疫苗的免疫程序提供参考。方法选取广西、江苏两省的六个县作为研究现场,在每个县选取一个手足口病(Hand-Foot-Mouth Disease, HFMD)高发乡和一个HFMD低发乡,采用系统随机抽样的方法选取符合条件的研究对象(新生儿及母亲组除外),对选取的0～15岁人群及新生儿母亲采集静脉血标本,并对他们(或其家长)进行问卷调查。采用中和试验对血标本进行EV71和CVA16NA检测。结果1.EV71NA水平：1.1所有调查对象的EV71NA阳性率为48.7%。不同年龄组EV7I NA阳性率的变化趋势为：新生儿的EV71NA阳性率较高(75.2%),随后逐渐降低,至6月龄降至最低(10%);≥1岁各年龄组的EV71NA阳性率迅速上升,其中6～10岁组的阳性率最高(87.5%)。各县及不同性别各年龄组的EV71NA阳性率变化趋势与总的变化趋势相似。1.2六个县全部调查对象的EV71NA几何平均滴度(Geometric MeanTiter,GMT)为1：17.70,1月龄至9～11月龄的EV71NA GMT均≤1：10,其中5月龄组最低(1：5.10)；1岁各年龄组的EV71NAGMT上升,其中4岁组最高(1：95.77)。不同县及不同性别各年龄组的EV71NAGMT曲线与总的EV71NAGMT曲线相似。1.3既往有病史者的EV71NA阳性率及GMT分别为77.3%和1：232.91,既往无病史者的EV71NA阳性率和GMT分别为48.4%和1：17.35,既往有病史者的EV71NA阳性率和GMT均高于既往无病史者(X2=7.2545,P=O.0071；t=6.49,P0.0001)。2.CVA16NA水平：六个县的CVA16阳性率及GMT普遍偏低。2.1全部调查对象的CVA16NA阳性率为34.7%。不同年龄组CVA16NA阳性率的变化趋势为：1岁各月龄组调查对象的CVA16NA阳性率随年龄的增长而下降,其中9-11月龄组最低(7.1%)；≥1岁各年龄组CVA16NA阳性率逐渐上升,其中6-10岁组的CVA16NA阳性率最高(72.1%)。不同年龄、不同县调查对象的CVA16NA阳性率差异均有统计学意义,但男、女性(VA16NA的阳性率差异无统计学意义。2.2六个县全部调查对象的CVA16NAGMT为1：8.44,≤1岁各年(月)龄组的CVA16NA GMT均较低(1：10),1岁各年龄组CVA16NA GMT上升,5岁组最高(1：22.97)。各县及不同性别的分年龄组NAGMT曲线与总NA的GMT曲线相似。2.3不同病史者的CVA16NA阳性率及GMT差异均无统计学意义(χ2=1.1414,P0.2845;t=I.4,P=0.1771)。3.与CVA16NA阳性率及GMT相比,除4月龄、5月龄、6月龄、7月龄、8月龄、1岁组及蒙山县外,EV71NA阳性率及GMT均较高。4.母亲EV71和CVA16的NA阳性率和GMT分别为83.5%、33.1%和1：26.61、1：6.11,新生儿EV71和CVA16的NA阳性率和GMT分别为75.2%、35.5%和1：22.05、1：6.97,母婴EV71、CVA16的NA阳性率及GMT差异均无统计学意义(X2EV71=2.52,P=0.1124;X2CVA16=0.1650, P=0.6846; tEV71=1.05, P=0.2953;tCVA16=1.30P=0.1946)。 EV71、CVA16NA阳性率和GMT在HFMD高、低发县差异也无统计学意义(X2EV71=1.45, P=0.2288; X2CVA16=1.28,P=0.2538; tEV71=1.86,P=0.0643; tCVA16=0.2P=.8399)。母婴EV71和CVA16NA滴度均存在相关性(rEV71=0.69,P0.0001;rCVA16=0.48,P0.0001)。5.部分调查对象存在EV71和(CVA16NA双阳性情况。EV71和CVA16NA双阳性率、EV71NA单阳性率、CVA16NA单阳性率及EV71和CVA16NA双阴性率分别为24.8%、23.9%、9.9%和41.4%。结论1.5～6月龄儿童的母传抗体衰减至最低：1岁开始EV71自然感染率明显升高。2.六个县0～15岁人群的CVA16NA阳性率及GMT均较低,有发生由CVA16引起的HFMD暴发的危险。3.母亲的EV71和CVA16NA阳性率及GMT高,新生儿的阳性率和GMT也会相应的高,母传抗体是预防小年龄组儿童发病的主要因素,可为生命早期的婴儿提供有效保护。4.母传EV71和CVA16NA滴度较低,而自然感染获得的EV71和CVA16NA滴度较高。5.EV71和CVA16存在大量隐性感染的情况。6.该六个县近几年HFMD病原体EV71的流行率高于CVA16。
[Abstract]:Objective To investigate the horizontal distribution of EV71 and CVA16NA in six counties from 0 to 15 years of age, including Enterovirus type 71 (EV71) and Coxsackie virus A group 16 (CVA16), and to investigate the horizontal distribution of EV71 and CVA16NA of the population: the horizontal survey of EV71 and CVA16NA by mother-to-child pairing, To understand the characteristics of maternal and infant EV71 and CVA16NA levels, and to provide reference for the development of the immune procedure for EV71 inactivated vaccines. Methods Six counties of Guangxi and Jiangsu were selected as the study site. One hand and foot-foot-mouth disease (HFMD) and one HFMD were selected in each county. Venous blood samples were collected from the selected 0-15-year-old population and the newborn's mother, and a questionnaire was conducted to them (or their parents). The blood samples were tested by neutralization test with EV71 and CVA16NA. Results 1. EV71NA level: 1.1 The EV71NA positive rate of all the investigated subjects was 48.7%. The positive rate of EV7I in the different age group was higher (75.2%), and then gradually decreased to the lowest (10%). The positive rate of EV71NA in all age groups in the 1-year-old age group increased rapidly, and the positive rate of EV71 in the 6 to 10-year-old group was the highest (87.5%). The trend of EV71NA positive rate in all counties and different sex groups was similar to that in the overall trend. The geometric mean titer (GMT) of EV71NA of all the survey subjects in the six counties was 1: 17.70, and the EV71NA GMT of 1 month to 9-11 months was 1:10, with the lowest (1: 5.10) in the 5-month-old group; The 1-year-old age group's EV71NAGMT rose, with the highest (1: 95.77) in the 4-year-old group. The EV71NAGMT curve of each age group in different counties and different sexes was similar to that of the overall EV71NAGMT curve. 1.3 The positive rate of the EV71NA and the GMT of the previous medical history were 77.3% and 1: 232.91, respectively. The positive rate of the EV71NA and the GMT of the prior non-medical history were 48.4% and 1: 17.35, respectively. The positive rate of EV71 NA and GMT of the prior medical history were higher than those of the prior non-medical history (X2 = 7.2545, P = O.0071; t = 6.49, P.0001).2. CVA16NA: the positive rate of CVA16 and GMT in six counties was generally lower. 2.1 The positive rate of CVA16NA in all the investigated subjects was 34.7%. The positive rate of CVA16NA in different age groups was: the positive rate of CVA16NA in the 1-year-old group decreased with the increase of age, of which 9-11-month-old group was the lowest (7.1%), and the positive rate of CVA16NA in all age groups in the 1-year-old group was increasing, and the positive rate of CVA16NA in the 6-10-year-old group was the highest (72.1%). There was a significant difference in the positive rate of CVA16NA in different age and in different counties, but the positive rate of the male and female (VA16NA) was not statistically significant. The CVA16NAGMT of all the survey subjects in the six counties was 1: 8.44, and the CVA16NA GMT of the first year of the year (month) was lower (1: 10) The CVA16NA GMT in the 1-year-old age group was up and the 5-year-old group was the highest (1: 22.97). The positive rates of CVA16NA and GMT of different patients with different medical history were not statistically significant (Sup2 = 1.1414, P0.2845; t = I.4, P = 0.1771). Compared with the positive rate of CVA16A and GMT, the positive rate and GMT of EV71NA were higher than that of the 4-month-old,5-month-old,6-month-old,7-month-old,8-month-old,1-year-old group and Mengshan county. The positive rates of NA and GMT of the mothers EV71 and CVA16 were 83.5%, 33.1% and 1: 26.61,1: 6.11, the positive rates of NA and GMT of the neonates EV71 and CVA16 were 75.2%, 35.5% and 1: 22.05,1: 6.97, and the positive rates of NA and GMT of the mother and child EV71 and CVA16 were not statistically significant (X2EV71 = 2.52, P = 0.1124; X2CVA16 = 0.1650, P = 0.6846; tEV71 = 1.05, P = 0.2953; tCVA16 = 1.30 P = 0.1946). The positive rates of EV71, CVA16A and GMT were not significant (X2EV71 = 1.45, P = 0.2288; X2CVA16 = 1.28, P = 0.2538; tEV71 = 1.86, P = 0.0643; tCVA16 = 0.2P =.8399). There was a correlation between the titer of EV71 and CVA16NA (rV71 = 0.69, P.0001; rCVA16 = 0.48, P0.001). Some of the investigated subjects were EV71 and (CVA16NA double positive). The positive rate of EV71 and CVA16NA, the positive rate of EV71 NA, the positive rate of CVA16NA and the double negative rate of EV71 and CVA16NA were 24.8%, 23.9%, 9.9% and 41.4%, respectively. Conclusion The maternal antibody of children from 1.5 to 6 months of age is attenuated to the minimum: the natural infection rate of EV71 is increased obviously at the age of 1. The positive rate and GMT of CVA16NA in six counties from 0 to 15 years were lower, and there was a risk of an outbreak of HFMD caused by CVA16. The positive rate of EV71 and CVA16A of the mother and the GMT are high, and the positive rate and GMT of the newborn are also high. The maternal antibody is the main factor to prevent the incidence of children in the small age group, and can provide effective protection for infants in the early stage of life. The titres of EV71 and CVA16A were lower, and the titers of EV71 and CVA16NA obtained by natural infection were higher.5. There was a large number of recessive infections in EV71 and CVA16. The prevalence of HFMD pathogen EV71 in the six counties has been higher than that of CVA16 in recent years.
【学位授予单位】：中国疾病预防控制中心
【学位级别】：硕士
【学位授予年份】：2012
【分类号】：R725.1
本文编号：2504755
[Abstract]:Objective To investigate the horizontal distribution of EV71 and CVA16NA in six counties from 0 to 15 years of age, including Enterovirus type 71 (EV71) and Coxsackie virus A group 16 (CVA16), and to investigate the horizontal distribution of EV71 and CVA16NA of the population: the horizontal survey of EV71 and CVA16NA by mother-to-child pairing, To understand the characteristics of maternal and infant EV71 and CVA16NA levels, and to provide reference for the development of the immune procedure for EV71 inactivated vaccines. Methods Six counties of Guangxi and Jiangsu were selected as the study site. One hand and foot-foot-mouth disease (HFMD) and one HFMD were selected in each county. Venous blood samples were collected from the selected 0-15-year-old population and the newborn's mother, and a questionnaire was conducted to them (or their parents). The blood samples were tested by neutralization test with EV71 and CVA16NA. Results 1. EV71NA level: 1.1 The EV71NA positive rate of all the investigated subjects was 48.7%. The positive rate of EV7I in the different age group was higher (75.2%), and then gradually decreased to the lowest (10%). The positive rate of EV71NA in all age groups in the 1-year-old age group increased rapidly, and the positive rate of EV71 in the 6 to 10-year-old group was the highest (87.5%). The trend of EV71NA positive rate in all counties and different sex groups was similar to that in the overall trend. The geometric mean titer (GMT) of EV71NA of all the survey subjects in the six counties was 1: 17.70, and the EV71NA GMT of 1 month to 9-11 months was 1:10, with the lowest (1: 5.10) in the 5-month-old group; The 1-year-old age group's EV71NAGMT rose, with the highest (1: 95.77) in the 4-year-old group. The EV71NAGMT curve of each age group in different counties and different sexes was similar to that of the overall EV71NAGMT curve. 1.3 The positive rate of the EV71NA and the GMT of the previous medical history were 77.3% and 1: 232.91, respectively. The positive rate of the EV71NA and the GMT of the prior non-medical history were 48.4% and 1: 17.35, respectively. The positive rate of EV71 NA and GMT of the prior medical history were higher than those of the prior non-medical history (X2 = 7.2545, P = O.0071; t = 6.49, P.0001).2. CVA16NA: the positive rate of CVA16 and GMT in six counties was generally lower. 2.1 The positive rate of CVA16NA in all the investigated subjects was 34.7%. The positive rate of CVA16NA in different age groups was: the positive rate of CVA16NA in the 1-year-old group decreased with the increase of age, of which 9-11-month-old group was the lowest (7.1%), and the positive rate of CVA16NA in all age groups in the 1-year-old group was increasing, and the positive rate of CVA16NA in the 6-10-year-old group was the highest (72.1%). There was a significant difference in the positive rate of CVA16NA in different age and in different counties, but the positive rate of the male and female (VA16NA) was not statistically significant. The CVA16NAGMT of all the survey subjects in the six counties was 1: 8.44, and the CVA16NA GMT of the first year of the year (month) was lower (1: 10) The CVA16NA GMT in the 1-year-old age group was up and the 5-year-old group was the highest (1: 22.97). The positive rates of CVA16NA and GMT of different patients with different medical history were not statistically significant (Sup2 = 1.1414, P0.2845; t = I.4, P = 0.1771). Compared with the positive rate of CVA16A and GMT, the positive rate and GMT of EV71NA were higher than that of the 4-month-old,5-month-old,6-month-old,7-month-old,8-month-old,1-year-old group and Mengshan county. The positive rates of NA and GMT of the mothers EV71 and CVA16 were 83.5%, 33.1% and 1: 26.61,1: 6.11, the positive rates of NA and GMT of the neonates EV71 and CVA16 were 75.2%, 35.5% and 1: 22.05,1: 6.97, and the positive rates of NA and GMT of the mother and child EV71 and CVA16 were not statistically significant (X2EV71 = 2.52, P = 0.1124; X2CVA16 = 0.1650, P = 0.6846; tEV71 = 1.05, P = 0.2953; tCVA16 = 1.30 P = 0.1946). The positive rates of EV71, CVA16A and GMT were not significant (X2EV71 = 1.45, P = 0.2288; X2CVA16 = 1.28, P = 0.2538; tEV71 = 1.86, P = 0.0643; tCVA16 = 0.2P =.8399). There was a correlation between the titer of EV71 and CVA16NA (rV71 = 0.69, P.0001; rCVA16 = 0.48, P0.001). Some of the investigated subjects were EV71 and (CVA16NA double positive). The positive rate of EV71 and CVA16NA, the positive rate of EV71 NA, the positive rate of CVA16NA and the double negative rate of EV71 and CVA16NA were 24.8%, 23.9%, 9.9% and 41.4%, respectively. Conclusion The maternal antibody of children from 1.5 to 6 months of age is attenuated to the minimum: the natural infection rate of EV71 is increased obviously at the age of 1. The positive rate and GMT of CVA16NA in six counties from 0 to 15 years were lower, and there was a risk of an outbreak of HFMD caused by CVA16. The positive rate of EV71 and CVA16A of the mother and the GMT are high, and the positive rate and GMT of the newborn are also high. The maternal antibody is the main factor to prevent the incidence of children in the small age group, and can provide effective protection for infants in the early stage of life. The titres of EV71 and CVA16A were lower, and the titers of EV71 and CVA16NA obtained by natural infection were higher.5. There was a large number of recessive infections in EV71 and CVA16. The prevalence of HFMD pathogen EV71 in the six counties has been higher than that of CVA16 in recent years.
【学位授予单位】：中国疾病预防控制中心
【学位级别】：硕士
【学位授予年份】：2012
【分类号】：R725.1
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