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目的了解广州市番禺区2014年健康人群麻疹、风疹、破伤风、水痘的免疫水平,为评价免疫效果、制定疫苗实施的策略提供科学依据。方法采用分层随机抽样方法确定被调查对象,采集血液标本共241份,进行麻疹、风疹、水痘的抗体以及破伤风抗毒素水平监测,同时收集个案资料进行4种疾病抗体阳性率的比较。结果纳入调查的241人中,麻疹、风疹、水痘抗体、破伤风抗毒素阳性率分别为95.85%、83.40%、60.17%和50.21%。不同性别间4种疾病抗体阳性率差异均无统计学意义(麻疹:Fisher确切概率法,P>0.05;风疹:χ2=0.074、水痘:χ2=0.051、破伤风:χ2=0.950,P>0.05)。不同年龄组间抗体阳性率差异均有统计学意义(麻疹:Fisher确切概率法,P<0.01;风疹:Fisher确切概率法,P<0.05;水痘:χ2=26.74,P<0.01;破伤风:χ2=48.63,Fisher确切概率法,P<0.01)。除水痘抗体阳性率城区高于乡镇外,麻疹、风疹抗体阳性率城区均低于乡镇,差异有统计学意义(麻疹:Fisher确切概率法,P<0.01;风疹:χ2=4.84,P<0.05;水痘:χ2=4.66,P<0.05);破伤风的抗体阳性率城区低于乡镇,差异无统计学意义(χ2=0.20,P>0.05)。有免疫史者4种疾病抗体阳性率高于无免疫史者,且差异有统计学意义(麻疹:Fisher确切概率法,P<0.05;风疹:χ2=14.98,P<0.01;水痘:χ2=4.01,P<0.05;破伤风:χ2=19.37,P<0.01)。结论广州市番禺区健康人群麻疹、风疹抗体水平较好,但水痘和破伤风抗体水平较低,存在薄弱地区与人群。应加强常规免疫接种和免疫水平监测,同时加强查漏补种工作。
Objective To understand the immune status of measles, rubella, tetanus and chickenpox in Panyu District of Guangzhou City in 2014 and provide a scientific basis for evaluating the immune effect and formulating the vaccine implementation strategy. Methods A total of 241 blood samples were collected by stratified random sampling method. Blood samples were collected for measles, rubella, chickenpox and tetanus antitoxin monitoring. Meanwhile, case-specific data were collected to compare the antibody positive rates of the four diseases. Results The positive rate of measles, rubella, chickenpox and tetanus antitoxin in the 241 investigated patients were 95.85%, 83.40%, 60.17% and 50.21% respectively. There was no significant difference in the positive rates of the four disease antibodies among different sexes (measles: Fisher exact test, P> 0.05; rubella: χ2 = 0.074, chickenpox: χ2 = 0.051, tetanus: χ2 = 0.950, P> 0.05) . Antibodies positive rates among different age groups were statistically significant (measles: Fisher exact probability method, P <0.01; Rubella: Fisher exact probability method, P <0.05; chickenpox: χ2 = 26.74, P <0.01; = 48.63, Fisher exact test, P <0.01). The positive rates of measles and rubella were lower in urban than in township, except for the positive rate of chickenpox antibody in urban area than in township (Measles: Fisher exact probability method, P <0.01; Rubella: χ2 = 4.84, P <0.05; Chickenpox: χ2 = 4.66, P <0.05). The positive rate of tetanus antibody in the urban area was lower than that in the township, the difference was not statistically significant (χ2 = 0.20, P> 0.05). The antibody positive rate of 4 kinds of diseases with immune history was higher than those without immune history, and the difference was statistically significant (measles: Fisher exact probability method, P <0.05; rubella: χ2 = 14.98, P <0.01; chickenpox: χ2 = 4.01 , P <0.05; tetanus: χ2 = 19.37, P <0.01). Conclusion The levels of measles and rubella in healthy population in Panyu District of Guangzhou City are good, but the antibody level of chickenpox and tetanus is low, with weak areas and population. Routine immunization and immunization monitoring should be strengthened, while leak detection and replanting should be strengthened.