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目的了解浙江省温州市<8月龄婴儿麻疹高发的原因,为探讨降低小月龄婴儿麻疹发病免疫策略提供依据。方法采用描述性流行病学方法,分析温州市2009-2013年<8月龄350例婴儿麻疹的分布特征;以麻疹确诊病例为病例组,非麻疹病例为对照组,用logistic回归分析法研究危险因素;对血清抗体浓度检测并进行χ2检验。结果温州市2009-2013年年均麻疹发病率为83.05/10万,<8月龄婴儿麻疹病例占总病例数的35.79%,主要集中在6~8月龄。与发病前7~21天去医院就诊相比,无医院就诊史的OR值为0.68(95%CI:0.49~0.94);与外地户籍比,本地户籍人口<8月龄麻疹发生的OR值为0.53(95%CI:0.39~0.72);居住在现住址≤3月龄麻疹发生的OR值为1.53(95%CI:1.07~2.18)。新生儿和6月龄婴儿的平均抗体浓度分别为214.94 IU/L和86.38 IU/L,麻疹血清抗体浓度显示健康婴儿6月龄时仅有18.07%的免疫保护力。结论 <8月龄婴儿麻疹抗体浓度较低是麻疹发病的易感人群,院内感染和流动人口是发病的危险因素。建议对育龄妇女婚前接种含麻疹成分的疫苗,以提高母传麻疹抗体的水平。同时加强流动人口管理和院内感染控制工作。
Objective To understand the causes of high incidence of measles in infants <8 months of age in Wenzhou City, Zhejiang Province, and to provide evidence for the strategy of reducing the incidence of measles in small month-old infants. Methods Descriptive epidemiological methods were used to analyze the distribution characteristics of 350 measles infants aged <8 months from 2009 to 2013 in Wenzhou City. Measured by measles cases as case group and non-measles cases as control group, the risk was analyzed by logistic regression analysis Factors; Serum antibody concentration test and χ2 test. Results The average annual incidence of measles in Wenzhou from 2009 to 2013 was 83.05 per 100 000. The number of measles cases in infants aged <8 months accounted for 35.79% of the total cases, mainly ranging from 6 to 8 months. The odds ratio of no hospital visit was 0.68 (95% CI: 0.49 ~ 0.94) compared with that of 7-21 days before the onset of hospitalization. Compared with the foreign household register, the OR of the local household population <8 months old measles was 0.53 (95% CI: 0.39 ~ 0.72). The odds ratio for measles that lived at ≤ 3 months old was 1.53 (95% CI: 1.07-2.18). The mean antibody concentrations in newborns and 6-month-old infants were 214.94 IU / L and 86.38 IU / L, respectively. Measles serum antibody concentrations showed only 18.07% immunoprotective power at 6 months of age in healthy infants. Conclusion The low measles antibody level in 8-month-old infants is a susceptible population of measles. Nosocomial infection and floating population are the risk factors. Proposed vaccination of women of childbearing age with pre-marital measles vaccine to increase the level of measles-maternal antibodies. At the same time strengthen the management of floating population and nosocomial infection control.