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2015年江苏省2-7岁儿童接种麻疹-腮腺炎-风疹疫苗后腮腺炎免疫情况研究

[Study of mumps immunity after administrating measles-mumps-rubella vaccine among children aged 2-7 years old in Jiangsu Province in 2015].

作者信息

Liu Y B, Hu Y, Deng X Y, Wang Z G, Sun X, Lu P S, Guo H X, Tang F Y, Zhou M H

机构信息

Division of Expanded Programme Immunization, Jiangsu Center for Disease Control and Prevention, Nanjing 210009, China.

出版信息

Zhonghua Yu Fang Yi Xue Za Zhi. 2017 Jul 6;51(7):593-597. doi: 10.3760/cma.j.issn.0253-9624.2017.07.004.

Abstract

To investigate the immunity to mumps after administrating measles-mumps-rubella vaccine (MMR) among children aged 2-7 years old in Jiangsu province in 2015. A total of 4 190 healthy children aged 2-7 years old, living in local places for at least 3 months, and having been vaccinated at least 1 dose MMR were recruited to the study from Wujin district of Changzhou city, Gaogang district of Taizhou city and Ganyu district of Lianyungang city by using stratified cluster random sampling method between September and November, 2015. Those who did not accept MMR vaccination, who refused venous blood collection, who had affected mumps according to the memory of parents or teachers and who were diagnosed serious disease by clinical doctors were excluded from study. The self-designed questionnaire was used to collect the general information of the subjects and their MMR immunization history; and 0.5-2.0 ml of venous blood was collected from each subject. ELISA was used to detect the mumps antibody level in the serum of patients. Positive was defined as the antibody level ≥108 mU/ml, and negative as <108 mU/ml. χ(2) test was used to compare the difference in positive rates among subjects; and analysis of variance was used to compare the GMC changes in different time points after MMR vaccination. Among 4 190 children, 2 280 were males (54.42%) and 1 910 were females(45.58%), and the positive rate of IgG antibody was 81.38% (3 344). There were 3 156 (95.18%) children vaccinated with one dose MMR, 187 (4.80%) children with two dose MMR, and 1 (0.02%) child with three dose MMR. The difference in positive rate of IgG antibody among different aged subjects showed statistical significance (χ(2)=58.61, 0.001), the highest positive rate was in group of subjects aged 4-5 years old, at 89.43% (406/454), while the lowest positive rate was found among subjects aged 6-7 years old, at 75.63% (1 648/2 179). The positive rate after one dose of MMR vaccination was 79.14% (3 156/3 988), significantly less than it after two doses (93.03%, 187/201) (χ(2)=22.93, 0.001). The GMC level at years<1, 1-<2, 2-<3, 3-<4, ≥4 following one dose MMR in the 3 988 children was 152.47, 227.78, 167.08, 126.91, 79.43 mU/ml, whose difference was statistically significant (51.29, 0.001). The sero-prevalence of IgG antibody in the children aged 2-7 years old in Jiangsu province was high. The positive rate among who received two doses MMR was significantly higher than it among who received just one dose, and the GMC level waned with times.

摘要

为调查2015年江苏省2 - 7岁儿童接种麻疹 - 腮腺炎 - 风疹疫苗(MMR)后的腮腺炎免疫情况。采用分层整群随机抽样方法,于2015年9月至11月从常州市武进区、泰州市高港区和连云港市赣榆区招募了4190名2 - 7岁的健康儿童,这些儿童在当地居住至少3个月,且至少接种过1剂MMR。未接种MMR疫苗、拒绝静脉采血、根据家长或老师回忆曾患腮腺炎以及临床医生诊断为患有严重疾病的儿童被排除在研究之外。采用自行设计的问卷收集研究对象的一般信息及其MMR免疫史;并从每个研究对象采集0.5 - 2.0 ml静脉血。采用ELISA法检测患者血清中的腮腺炎抗体水平。抗体水平≥108 mU/ml定义为阳性,<108 mU/ml定义为阴性。采用χ(2)检验比较研究对象之间阳性率的差异;采用方差分析比较MMR疫苗接种后不同时间点的几何平均浓度(GMC)变化。在4190名儿童中,男性2280名(54.42%),女性1910名(45.58%),IgG抗体阳性率为81.38%(3344名)。接种1剂MMR的儿童有3156名(95.18%),接种2剂MMR的儿童有187名(4.80%),接种3剂MMR的儿童有1名(0.02%)。不同年龄组研究对象的IgG抗体阳性率差异有统计学意义(χ(2)=58.61,P<0.001),4 - 5岁组阳性率最高,为89.43%(406/454),6 - 7岁组阳性率最低,为75.63%(1648/2179)。接种1剂MMR后的阳性率为79.14%(3156/3988),显著低于接种2剂后的阳性率(93.03%,187/201)(χ(2)=22.93,P<0.001)。3988名接种1剂MMR的儿童在<1年、1 - <2年、2 - <3年、3 - <4年、≥4年时的GMC水平分别为152.47、227.78、167.08、126.91、79.43 mU/ml,差异有统计学意义(F = 51.29,P<0.001)。江苏省2 - 7岁儿童IgG抗体血清阳性率较高。接种2剂MMR的儿童阳性率显著高于接种1剂的儿童,且GMC水平随时间下降。

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