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目的探讨婴幼儿对麻疹易感的原因并提出控制的策略。方法采集本院47例小于12月龄麻疹患儿的咽拭子和患儿及母亲的血清,同时采集13位幼年患过麻疹的育龄妇女血清作为对照。通过细胞培养测定血清中和抗体滴度,使用ELISA诊断试剂定量检测麻疹IgG和IgM抗体。根据抗体检测结果再分组进行统计学分析。结果 (1)47例患儿中,45例(95.7%)麻疹IgG抗体阴性;(2)麻疹IgM(-)组患儿母亲IgG抗体均值为1108 mIU/ml,明显低于对照组的2793 mIU/ml(P<0.05);(3)麻疹IgM(-)组患儿母亲麻疹中和抗体几何平均滴度(GMT)为1∶30,明显低于对照组的1∶182(P<0.05);(4)8例患儿母亲麻疹IgG抗体及中和抗体水平异常升高。结论 1岁以下幼儿患麻疹的主要原因是患儿没能从母体中获得足够的麻疹抗体;育龄妇女在怀孕前加强接种麻疹疫苗,是可行而又有效的提高婴幼儿对麻疹免疫力的方法。
Objective To explore the causes of measles susceptibility in infants and young children and to propose control strategies. Methods Throat swabs, serums of children and mothers from 47 children with measles of less than 12 months old were collected, and serum of 13 young women of childbearing age who had measles infection was collected as control. Serum neutralizing antibody titers were determined by cell culture and measles IgG and IgM antibodies were quantified using ELISA diagnostic reagents. According to antibody test results and then sub-group for statistical analysis. Results (1) Among the 47 children, 45 (95.7%) were negative for measles IgG antibody. (2) The mean IgG antibody level of mothers in measles IgM (-) group was 1108 mIU / ml, which was significantly lower than that of the control group / ml (P <0.05). (3) The geometric mean titer (GMT) of measles neutralizing antibody in maternal measles IgM (-) group was 1:30, significantly lower than that in the control group (P <0.05) ; (4) 8 cases of mothers with measles IgG antibodies and neutralizing antibody levels were abnormally elevated. Conclusions The main cause of measles in infants under 1 year old is that the children can not get enough measles antibody from their mother. Strengthening the vaccination of measles before pregnancy is a feasible and effective way to improve the immunity of measles to infants and children.