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[国产麻疹、腮腺炎和风疹联合减毒活疫苗不同接种策略后的抗体持久性:一项3年随访研究]

[Antibody persistence following on different vaccination strategies of domestic measles, mumps and rubella combined attenuated live vaccine: a 3-year follow-up study].

作者信息

He H Q, Li Q, Yan R, Zhou Y, Tang X W, Deng X, Xie S Y, Chen Z P

机构信息

Expanded Program Immunization Department of Zhejiang Provincial Center for Diseases Control and Prevention, Hangzhou 310051, China.

出版信息

Zhonghua Yu Fang Yi Xue Za Zhi. 2017 Apr 6;51(4):336-340. doi: 10.3760/cma.j.issn.0253-9624.2017.04.011.

Abstract

To assess the 3-year antibody persistence after vaccination of domestic measles, mumps and rubella combined attenuated live vaccine (MMR) with different program. Children from three different vaccination strategies (Group 8 m MR: 8 months and 18 months vaccinated with measles-rubella combined attenuated live vaccine and domestic MMR,respectively; Group 8 m MMR: 8 months and 18 months both vaccinated with domestic MMR; Group 12 m MMR: 12 months and 22 months both vaccinated with domestic MMR ) were followed up in Zhejiang province in July 2015. There were 170 participants in Group 8 m MR, 171 participants in Group 8 m MMR and 173 participants in Group 12 m MMR selected by simple random sampling method .Blood samples (venous blood 2-3 ml) were collected 1 month after the first dose vaccination of MMR (only in Group 8 m MMR and Group 12 m MMR) and 3 years (36-38 months) after the last dose vaccination of MMR and tested for antibody IgG against Measles, Mumps and Rubella using ELISA. Seropostive rate and Geometric mean concentration (GMC) were calculated and compared among different groups by Chi-square test or Fisher exact test and Kruskal-Wallis test. A total of 514 participants (8 m MR: 170; 8 m MMR:171; 12 m MMR:173) were enrolled. The overall seropositivity rate of measles, mumps and rubella was 98.1% (504), 93.4% (480) and 88.1% (453), respectively, with corresponding GMC was 1 012.33 mU/ml, 502.87 U/ml and 50.53 U/ml respectively. There was no significant difference of seropositivity rate for measles among three groups (all groups were>97%). The highest seropositivity rate for mumps was found in the Group 12 m MMR with the rate of 98.8% (171/173), followed by Group 8 m MMR and Group 8 m MR with 93.0% (159/171) and 88.2%(150/170) respectively (Fisher exact test, 0.001). The highest seropositivity rate for rubella was also found in the Group 12 m MMR with the rate of 94.8% (164/173), followed by Group 8 m MMR and Group 8 m MR with 86.6%(148/171) and 82.9%(141/170) respectively (Fisher exact test, 0.002). The highest GMC of antibody against measles, mumps and rubella were all found in Group 12 m MMR, with 1 217.30 (1 119.35-1 323.82) mU/ml, 717.07 (643.83-798.65) U/ml and 62.54(56.21-69.58) U/ml respectively. The lowest GMC of antibody against measles and mumps were both in Group 12 m MR with 812.01 (734.52-897.67) mU/ml and 363.28 (305.42-432.11) U/ml respectively. The lowest GMC of antibody against rubella was in Group 8 m MMR with 44.10 (39.08-49.76) U/ml. These differences of GMCs among three groups were all reach significant means (0.05). High level seropostive rates and GMCs were exist against measles and rubella after 3-year vaccination of domestic MMR among different program. Higher antibody level against mumps were found in those children with two doses vaccination of MMR.

摘要

评估国产麻疹、腮腺炎和风疹联合减毒活疫苗(MMR)不同接种程序接种后3年的抗体持久性。2015年7月,在浙江省对来自三种不同接种策略的儿童进行了随访(8月龄MR组:分别于8月龄和18月龄接种麻疹风疹联合减毒活疫苗和国产MMR;8月龄MMR组:8月龄和18月龄均接种国产MMR;12月龄MMR组:12月龄和22月龄均接种国产MMR)。通过简单随机抽样方法,在8月龄MR组选取170名参与者,8月龄MMR组选取171名参与者,12月龄MMR组选取173名参与者。在MMR首剂接种后1个月(仅在8月龄MMR组和12月龄MMR组)以及MMR末次接种后3年(36 - 38月龄)采集血样(静脉血2 - 3 ml),采用ELISA法检测麻疹、腮腺炎和风疹抗体IgG。计算血清阳性率和几何平均浓度(GMC),并通过卡方检验或Fisher确切检验以及Kruskal - Wallis检验对不同组进行比较。共纳入514名参与者(8月龄MR组:170名;8月龄MMR组:171名;12月龄MMR组:173名)。麻疹、腮腺炎和风疹的总体血清阳性率分别为98.1%(504名)、93.4%(480名)和88.1%(453名),相应的GMC分别为1012.33 mU/ml、502.87 U/ml和50.53 U/ml。三组麻疹血清阳性率无显著差异(所有组均>97%)。腮腺炎血清阳性率最高的是12月龄MMR组,为98.8%(171/173),其次是8月龄MMR组和8月龄MR组,分别为93.0%(159/171)和88.2%(150/170)(Fisher确切检验,P = 0.001)。风疹血清阳性率最高的也是12月龄MMR组,为94.8%(164/173),其次是8月龄MMR组和8月龄MR组,分别为86.6%(148/171)和82.9%(141/170)(Fisher确切检验,P = 0.002)。麻疹、腮腺炎和风疹抗体的最高GMC均在12月龄MMR组,分别为1217.30(1119.35 - 1323.82)mU/ml、717.07(643.83 - 798.65)U/ml和62.54(56.21 - 69.58)U/ml。麻疹和腮腺炎抗体GMC最低的均在8月龄MR组,分别为812.01(734.52 - 897.67)mU/ml和363.28(305.42 - 432.11)U/ml。风疹抗体GMC最低的在8月龄MMR组,为44.10(39.08 - 49.76)U/ml。三组GMC的这些差异均具有统计学意义(P<0.05)。国产MMR不同接种程序接种3年后,麻疹和风疹的血清阳性率和GMC处于较高水平。接种两剂MMR的儿童对腮腺炎的抗体水平较高。

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