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目的评价吸附无细胞百白破联合疫苗(Diphtheria,tetanus and acellular pertussis combined vaccine,DTaP)加强免疫单独接种和同时接种水痘减毒活疫苗(Varicella attenuated live vaccine,VarV)的免疫效果。方法选取满18月龄且已完成DTaP基础免疫的健康儿童218名,其中110人接种DTaP,108人同时接种DTaP和VarV。采用酶联免疫吸附试验(Enzyme-linked immunosorbent assay,ELISA)检测免疫前、后抗百日咳毒素抗体(Antibody to pertussis toxin,Anti-PT)、抗丝状血凝素抗体(Antibody to filamentous hemagglutmin,Anti-FHA)、抗白喉毒素抗体(Antibody to diphtheria toxin,Anti-DT)和抗破伤风毒素抗体(Antibody to tetanus toxin,Anti-TT),计算抗体几何平均浓度(Geometric Mean Concentration,GMC)和抗体阳转率(Seroconversion rate,SCR)。结果单独接种组和同时接种组免疫后Anti-PT、Anti-FHA、Anti-DT和Anti-TT的SCR分别为43.64%、81.48%(x~2=33.26,P=0.000),72.73%、85.19%(x~2=0.84,P=0.358),90.00%、85.18%(x~2=1.16,P=0.281),13.64%、11.11%(x~2=0.32,P=0.571);GMC分别为94.74IU/ml、98.86IU/ml(t=1.15,P=0.251),39.59IU/ml、44.10IU/ml(t=1.90,P=0.059),1.89IU/ml、1.47IU/ml(t=3.83,P=0.000),3.85IU/ml、2.72IU/ml(t=5.51,P=0.000)。两组Anti-PT、Anti-FHA免疫前阴性者免疫后SCR高于免疫前阳性者。同时接种组免疫后Anti-PT、Anti-FHA的GMC增长高于单独接种组,而免疫后Anti-DT、Anti-TT的GMC增长低于单独接种组。结论 DTaP加强免疫对预防百日咳的保护力有限,对预防白喉、破伤风的加强免疫时间可以延长,同时接种DTaP和VarV对DTaP的免疫原性无影响。
OBJECTIVE: To evaluate the immune effect of vaccination combined with DTV (Diphtheria tetanus and acellular pertussis combined vaccine, Varicella attenuated live vaccine, VarVella attenuated live vaccine (VarV)). Methods A total of 218 healthy children, aged 18 months and having completed the basic immune system of DTaP, were selected. Among them, 110 were inoculated with DTaP and 108 were inoculated with DTaP and VarV simultaneously. The anti-pertussis toxin (Anti-PT) and anti-fibrinogen antibody (Anti-PT) and anti-fibrinogen antibody (Anti-PT) before and after immunization were detected by Enzyme-linked immunosorbent assay (ELISA) (FHA), Antibody to diphtheria toxin (Anti-DT) and Antibody to tetanus toxin (Anti-TT). Geometric Mean Concentration (GMC) Seroconversion rate (SCR). Results The SCRs of Anti-PT, Anti-FHA, Anti-DT and Anti-TT after vaccination alone and simultaneously were 43.64%, 81.48% (x 2 = 33.26, P = 0.000), 72.73%, 85.19 (x ~ 2 = 0.84, P = 0.358), 90.00%, 85.18% (x ~ 2 = 1.16, P = 0.281), 13.64%, 11.11% (T = 1.90, P = 0.059), 1.89IU / ml, 1.47IU / ml (t = 1.15, P = 0.251), 39.59IU / ml, 44.10IU / ml 3.83, P = 0.000), 3.85 IU / ml, 2.72 IU / ml (t = 5.51, P = 0.000). The serum levels of SCR in Anti-PT and Anti-FHA before immunization in two groups were higher than those before immunization. At the same time, the GMC growth of Anti-PT and Anti-FHA in vaccinated group was higher than that of inoculation alone group, while the GMC growth of Anti-DT and Anti-TT in vaccinated group was lower than that of inoculation alone group. Conclusion The protective effect of DTaP boosting on prevention of whooping cough is limited. The duration of booster immunization against diphtheria and tetanus can be prolonged. At the same time DTaP and VarV have no effect on the immunogenicity of DTaP.