论文部分内容阅读
目的观察吸附无细胞百白破灭活脊髓灰质炎和b型流感嗜血杆菌(结合)联合疫苗(DTaP-IPV/Hib五联疫苗,简称五联苗)基础免疫后的脊髓灰质炎(简称脊灰)中和抗体水平,并与传统的口服脊灰减毒活疫苗(oral poliomyelitis attenuated live vaccine,OPV)免疫效果对比分析。方法选择无脊灰疫苗接种禁忌证的健康婴儿,按照接种疫苗的不同,分为五联苗组和OPV组,每组100人。收集每个研究对象的脐带血和基础免疫后的颈静脉血,以微量中和试验测定血清中脊灰病毒Ⅰ、Ⅱ、Ⅲ型中和抗体。将抗体几何平均滴度(geometric mean titer,GMT)进行对数转换,采用t检验、χ2检验比较免疫前后抗体水平差异。结果基础免疫后,两组Ⅰ、Ⅱ、Ⅲ型脊灰中和抗体水平较免疫前均有显著提高(P<0.01),保护率均达100%。五联苗组基础免疫后Ⅰ、Ⅱ、Ⅲ型脊灰中和抗体GMT分别为227.54、186.11、377.41,OPV组分别为1 217.75、680.29、418.77,两组Ⅰ、Ⅱ型抗体水平差异有统计学意义,五联苗低于OPV组(Ⅰ型:t=-10.80,P<0.01;Ⅱ型:t=-8.941,P=0.010);Ⅲ型抗体水平差异无统计学意义(t=-0.624,P=0.776)。基础免疫后Ⅰ、Ⅱ、Ⅲ型脊灰中和抗体水平与性别、出生体重、母传抗体水平无线性相关关系,Ⅰ、Ⅱ型抗体水平与采血间隔和接种疫苗的种类有线性相关关系。结论五联苗3剂次基础免疫后可提供针对脊灰的有效免疫保护,但Ⅰ、Ⅱ型抗体水平相对于OPV免疫后较低,建议对基础免疫时全程接种五联苗的儿童在4岁加强免疫时口服1剂次OPV。
Objective To observe the effect of poliomyelitis after poliomyelitis (referred to as poliomyelitis for short) on the adsorption of cell-free baicalin-abolished live-polio and Haemophilus influenzae type b (combined) combined vaccine (DTaP-IPV / Hib five-vaccine) ) Neutralizing antibody, and compared with the traditional oral poliomyelitis attenuated live vaccine (OPV). Methods Healthy infants with contraindications to polio-free vaccination were divided into five groups according to their vaccination groups and OPV group, with 100 in each group. Umbilical cord blood and jugular venous blood after basic immunization were collected from each subject, and the neutralizing antibodies of type I, II and III of poliovirus in serum were detected by micro neutralization test. The geometric mean titer (GMT) was logarithmically transformed. The t-test and χ2 test were used to compare the antibody levels before and after immunization. Results After basal immunization, the levels of neutralizing antibodies to type Ⅰ, Ⅱ and Ⅲ of poliomyelitis in both groups were significantly higher than those before immunization (P <0.01), and the protection rates were both 100%. The GPT of type I, II, and III poliovirus after the basic immunization of the combined vaccine group was 227.54, 186.11 and 377.41, respectively, and the OPV group was 1 217.75, 680.29 and 418.77 respectively. There were statistically significant differences in the antibody levels of type I and type II between the two groups (T = -0.80, P <0.01; type II: t = -8.941, P = 0.010). There was no significant difference in the levels of type III antibodies (t = -0.624, P = 0.776). There was no linear correlation between the levels of neutralizing antibodies of type Ⅰ, Ⅱ, and Ⅲ poliovirus and the sex, birth weight and mother antibody level after the basic immunization. The antibody levels of type Ⅰ and Ⅱ had a linear relationship with blood sampling interval and the type of vaccination. Conclusions Three doses of five-dose Miao-Pei-Miao can provide effective immunoprotection against polio after three doses of immunization. However, the level of antibodies against type I and II is lower after immunization compared with OPV. It is suggested that children immunized with five- Strengthen the immune oral OPV.