百日咳、白喉血清流行病学研究

发布时间：2018-09-12 12:58

【摘要】：目的:通过开展百日咳、白喉胎传抗体水平及阴转率、抗体阳转率、社区人群的抗体水平监测,对滨海新区乃至我国百日咳再现背景下的百日咳、白喉的预防接种策略的调整提供科学依据。方法:随机抽取132名新生儿,在出生时、满3月龄未接种无细胞百白破疫苗(DTa P)时、满6月龄即接种3剂次DTa P后1个月检测百日咳和白喉Ig G抗体。采取分层随机抽样方法,从社区健康人群中抽取619人做为研究对象,抽取其静脉血检测百日咳和白喉Ig G抗体。采用酶联免疫吸附试验检测百日咳Ig G抗体、白喉Ig G抗体。组间抗体阳性率的比较采用卡方检验。结果:1.新生儿百日咳胎传抗体阳性率为31.06%,男女婴间的差异无统计学意义;白喉胎传抗体阳性率为33.33%,男婴(38.16%)高于女婴(26.79%)(P0.05)。2.胎传抗体阳性新生儿满3月龄未接种DTa P时,百日咳胎传抗体阴转率为89.19%,白喉胎传抗体阴转率为94.60%,差异无统计学意义;男、女婴百日咳、白喉胎传抗体阴转率的差异均无统计学意义。3.新生儿满6月龄即接种3剂次DTa P后1个月,百日咳抗体阳转率为76.67%,白喉抗体阳转率100.00%,差异有统计学意义。4.社区健康人群百日咳和白喉抗体阳性率分别为50.57%和60.90%,男女性阳性率的差异均无统计学意义。15岁人群百日咳抗体阳性率为36.77%,低于15~58岁人群的64.40%(P0.05)。15岁人群中,未免疫人群百日咳抗体阳性率为16.98%,有疫苗接种史者抗体阳性率为40.94%,差异有统计学意义;随着免疫剂次增多百日咳抗体阳性率逐渐升高。而15岁人群白喉抗体阳性率为82.08%,高于15~58岁人群的40.45%,差异有统计学意义。15岁人群中,未免疫人群白喉抗体阳性率为35.85%,有疫苗接种史者抗体阳性率为91.34%,差异有统计学意义;随着免疫剂次增多白喉抗体阳性率逐渐升高。15岁人群中接种过DTa P疫苗者的白喉抗体阳性率(91.34%)高于百日咳抗体阳性率(40.94%),差异有统计学意义。结论:新生儿百日咳、白喉的胎传抗体阳性率低,有三分之二的新生儿无法获得母体胎传抗体的保护。3月龄时百日咳、白喉胎传抗体几乎完全转阴,3月龄前婴儿感染百日咳、白喉的风险高。DTa P基础免疫后百日咳抗体阳转率低于白喉抗体阳转率。社区人群百日咳抗体阳性率较低,尤其在处于免疫规划年龄的15岁以下人群。
[Abstract]:OBJECTIVE:To provide scientific basis for the adjustment of immunization strategy of pertussis and diphtheria in Binhai New Area and even in the background of pertussis recurrence in China by monitoring the levels and negative conversion rate of fetal borne antibodies to pertussis and diphtheria, positive conversion rate of antibodies, and antibody level of community population. The Ig G antibodies against pertussis and diphtheria were detected one month after three doses of DTa P were inoculated at the age of 6 months. A stratified random sampling method was used to detect the Ig G antibodies against pertussis and diphtheria in 619 healthy people in the community. Results: 1. The positive rate of fetal borne antibody in newborns with pertussis was 31.06%. There was no significant difference between male and female infants. The positive rate of fetal borne antibody in diphtheria was 33.33%. The positive rate of male infants (38.16%) was higher than that of female infants (26.79%) (P 0.05). There was no significant difference between male and female infants with pertussis or diphtheria. The positive rates of pertussis and diphtheria antibodies were 50.57% and 60.90% respectively in the healthy population of the community. There was no significant difference in the positive rates between men and women. The positive rate of diphtheria antibody in the 15-year-old group was 82.08%, which was higher than that in the 15-58-year-old group (40.45%). The difference was statistically significant. The positive rate of diphtheria antibody was 91.34%. The positive rate of diphtheria antibody was 91.34%. The positive rate of diphtheria antibody was 91.34% in the 15-year-old group who had been inoculated with DTap vaccine, which was higher than that of pertussis antibody (40.94%). Conclusion: There was a significant difference between the two groups. The positive rate of fetal transmission antibody was low, and two-thirds of the newborns could not get the protection of maternal transmission antibody. The positive rate was low, especially in those below 15 years of age.
【学位授予单位】：天津医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R181.3;R516.6;R517.1

【参考文献】