深圳市某区2013年水痘疫苗接种儿童抗体水平横断面研究

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摘要目的观察儿童水痘疫苗1剂次接种后的免疫持久性及其可能的影响因素,为水痘疫苗加强免疫方案提供参考依据。方法采用横断面流行病学,对年龄2-7岁水痘疫苗初次免疫间隔1-5年的健康儿童566名采集静脉血,使用膜免疫荧光法（FAMA）测定水痘IgG水平。同时收集疫苗生产厂家及初免年龄等,用卡方检验分析率的差异,方差分析、t检验用于分析抗体滴度变化,多重线性回归用于分析抗体滴度变化的影响因素。结果水痘疫苗初免间隔1年、间隔3年、间隔5年后抗体阳性率（93.7%,87.6%,89.9%）差异没有统计学显著性 (χ²=4.50,P=0.11),抗体滴度随时间衰减,不同间隔年限抗体水平有显著差异（F=12.606,P<0.001）,间隔1年组的抗体水平（GMTs1:11.5）显著高于间隔3年(1:7.14)、5年组(1:8.36)。间隔3年、5年组间抗体水平差异没有统计学意义。水痘疫苗初免年龄各间隔年限组间有显著差异（χ²=276.069,P<0.001）,间隔1年组初免年龄最小,间隔5年组最大。国产疫苗和进口疫苗接种者的抗体阳性率相当。初免年龄、性别、疫苗种类对抗体滴度的影响均没有统计学显著性。结论国产疫苗和进口疫苗接种后免疫持久性效果相当,虽然初免5年后,抗体阳性率能仍维持较高水平,但抗体滴度随时间延长有所衰减,接种3-5年后抗体维持较低水平;根据本研究得出的水痘疫苗免后抗体衰减规律,建议在初次免疫后3年考虑加强免疫。

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	马茂
	刘卫民
	杨洁
	林喜乐
	付丹凤
	何莲娇

关键词 ：水痘减毒活疫苗, 抗体水平, 膜免疫荧光法

Abstract：ObjectiveTo observe the long term immune effect and probable influence factors of 1 dose of varicella vaccination,for feasible reference of the strengthening immunization program. MethodsWe used cross-sectional study, a total of 566 healthy children aged 2~7 years old were selected, who had been injected with 1 dose of imported or domestic varicella vaccine for 1-5 years and without varicella disease history. Blood samples collected from them were detected by fluorescent antibody to membrane antigen test (FAMA). Chi-square test was used to compare rate; ANOVA, t-test to compare titles and multiple linear regression to find possible impact factors etc. ResultsThe antibody level decreased annually, geometric mean titers (GMTs) in children immunized for 1 year(1:11.5) was significantly higher than that in the ones immunized for three years and five years.（F=12.606,P<0.001）. But the positive rate showed no significant difference among the three groups(χ²=4.50,P=0.11). Distribution of primary immune age in all time interval groups statistically differed from each other( χ²=276.069,P<0.001) , shorter time interval group had lower primary immune age. Both primary immune age, gender and vaccine type (domestic or imported) had no significant influences on antibody levels. ConclusionDomestic and imported varicella vaccines had similar long term immune effect, although the antibody positive rate stayed high 5 years after primary injection, the antibody level decreased yearly, and kept stable low 3~5 years after inoculation. As the study showed how the antibodies waned, a booster immunization should be recommended 3 years after primary dose.

Key words： live attenuated Varicella vaccine Antibody level Fluorescent antibody to membrane antigen test (FAMA)

作者简介: 马茂（1984~）女,重庆市人,汉族,硕士,主管医师,主要研究方向为疫苗控制疾病监测、管理工作。 3

引用本文:

马茂, 刘卫民,杨洁,林喜乐,付丹凤,何莲娇. 深圳市某区2013年水痘疫苗接种儿童抗体水平横断面研究[J]. 实用预防医学, 2015, 22(12): 1451-1453. MA Mao, LIU Wei-min, YANG Jie, Lin Xi-le, FU Dan-feng, HE Lian-jiao. Cross-sectional study on varicella vaccination efficacy among children. , 2015, 22(12): 1451-1453.

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