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目的了解新生儿及其母亲肠道病毒71型(enterovirus 71,EV71)和柯萨奇病毒A组16型(coxsackievirus A16,Cox A16)中和抗体水平,为建立疫苗免疫程序提供科学依据。方法征集2013年7月~2014年4月在广州市荔湾区妇幼保健院进行分娩并经知情同意的产妇及其新生儿作为研究对象,共纳入181对母亲和新生儿。采用微量细胞病变抑制法检测EV71和Cox A16中和抗体,运用血清流行病学方法进行母传抗体消长特征研究。结果在纳入的181对母亲和新生儿中,母亲EV71和Cox A16中和抗体阳性率分别为83.98%和88.95%,几何平均滴度倒数(geometric mean reciprocal titer,GMRT)分别为25.42和27.00。新生儿EV71和Cox A16中和抗体阳性率分别为74.03%和71.82%,GMRT分别为20.50和16.48。新生儿的EV71和Cox A16中和抗体滴度与其母亲的EV71和Cox A16中和抗体滴度均呈正相关(r_(EV71)=0.70,P<0.001;r_(Cox A16)=0.75,P<0.001)。0~6月龄婴儿体内EV71和Cox A16中和抗体随月龄增加均呈下降趋势(χ_(EV71)~2=100.23,P<0.001;χ_(Cox A16)~2=112.24,P<0.001)。结论建议手足口病灭活疫苗在6月龄接种为宜,育龄期妇女接种手足口病疫苗能提高婴儿体内抗体水平,以降低小于6月龄婴儿发病率。
Objective To understand the levels of neutralizing antibodies in enterovirus 71 (EV71) and coxsackievirus A16 (Cox A16) in neonates and their mothers, and to provide a scientific basis for establishing vaccine immunization program. Methods A total of 181 mothers and newborns were enrolled in this study from July 2013 to April 2014 in Maternal and Child Health Hospital of Liwan District, Guangzhou. The detection of the neutralizing antibodies EV71 and Cox A16 by using the method of microcytopathy inhibition and the study on the characteristics of the growth and decline of the mother antibody by using the serum epidemiology method. Results The positive rates of mothers EV71 and Cox A16 neutralizing antibody were 83.98% and 88.95%, respectively, and the geometric mean reciprocal titer (GMRT) were 25.42 and 27.00 respectively among the 181 maternal and newborn infants. Neonates EV71 and Cox A16 neutralizing antibody positive rates were 74.03% and 71.82%, GMRT were 20.50 and 16.48. Neonatal EV71 and Cox A16 neutralizing antibody titers were positively correlated with their mothers’ EV71 and Cox A16 neutralizing antibody titers (r EV71 = 0.70, P <0.001; r Cox A16 = 0.75, P <0.001 ). The neutralizing antibodies of EV71 and Cox A16 in 0 ~ 6 month-old infants showed a decreasing trend with increasing age (χ EV71 2 = 100.23, P <0.001), χ Cox A16 2 112.24 (P 0.001) . Conclusions It is suggested that vaccination of hand, foot and mouth disease should be given at 6 months of age. Breeding hand-foot-mouth disease vaccine in women of childbearing age can increase the antibody level in infants and reduce the incidence of infants less than 6 months old.