论文部分内容阅读
目的探讨麻疹消除阶段IgG抗体亲和力应用于区分原发和继发性免疫失败麻疹病例的意义。方法采用酶联免疫吸附方法检测92例麻疹诊断病例(其中17例为一起学校麻疹暴发疫情病例)的血清IgM和IgG抗体水平,测定IgG抗体亲和力,计算相对亲和力指数。结果 17例暴发疫情病例的血清IgM阳性率为41.18%(7/17),IgG阳性率为100%(17/17),全部为高亲和力IgG抗体。在另75例IgM阳性病例中,IgG阳性率为76.00%(57/75),有高亲和力IgG抗体的病例占61.4%(35/57)。92例病例中未接种含麻疹成分疫苗(MCV)25例,有高亲和力IgG抗体的病例占48%(12/25);22例病例接种≥1剂MCV,有高亲和力IgG抗体的病例占77.27%(17/22)。MCV接种病例中继发性免疫失败麻疹病例17例,原发性免疫失败麻疹病例5例。结论麻疹IgG抗体亲和力测定可用于鉴别麻疹原发和继发性免疫失败病例,解决了中国消除麻疹的这一关键技术问题。
Objective To explore the significance of the affinity of IgG antibodies in the stage of measles elimination to distinguish the cases of primary and secondary immune failure measles. Methods The serum levels of IgM and IgG in 92 cases of measles diagnosed (17 cases of outbreaks of measles in school) were detected by enzyme-linked immunosorbent assay (ELISA). The affinity of IgG antibody was measured and the relative affinity index was calculated. Results The positive rate of serum IgM in 17 outbreak cases was 41.18% (7/17) and the positive rate of IgG was 100% (17/17), all of which were high affinity IgG antibodies. In the other 75 cases of IgM-positive cases, the positive rate of IgG was 76.00% (57/75), and the cases with high-affinity IgG antibodies accounted for 61.4% (35/57). Of the 92 cases, 25 cases were not vaccinated with measles vaccine (MCV), 48% (12/25) had high-affinity IgG antibody. 22 cases were vaccinated with ≥1 MCV and high-affinity IgG antibodies accounted for 77.27 % (17/22). Seventeen cases of secondary immunodeficiency in MCV-vaccinated cases and five cases of primary immunological failure in measles cases. Conclusion Measles IgG antibody affinity assay can be used to identify cases of primary and secondary measles immunization failure and solve the key technical issue of eliminating measles in China.