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目的评价脊髓灰质炎中和抗体在产妇及其婴儿体内消长规律,比较不同免疫程序下婴儿抗体水平变化。方法选取2013年7月—2014年4月在广州市荔湾区妇幼保健院进行分娩的产妇及其新生儿作为研究对象,采用血清流行病学方法对产妇及产妇所生婴儿0(新生儿)、3、6月龄脊灰中和抗体水平进行分析;并根据婴儿基础免疫程序将其分为脊髓灰质炎减毒活疫苗(OPV)组、脊髓灰质炎灭活疫苗(IPV)与IPV+OPV 3组,比较疫苗接种后的抗体水平。结果共采集179位产妇外周静脉血,婴儿0、3、6月龄时分别采血176、149、62份。新生儿较产妇I、II、III型脊灰中和抗体水平有所下降,3、6月龄时抗体水平均大幅上升,6月龄时各型分别高达607.0(95%CI=146.0~2 523.1)、239.6(95%CI=80.4~713.6)和235.9(95%CI=56.0~994.8)。OPV、IPV、IPV+OPV组在婴儿各个时间段脊灰I、II、III型抗体几何平均滴度倒数(GMRT)和抗体阳性率差异均无统计学意义(均P>0.05)。产妇脊灰抗体水平与新生儿脊灰Ⅱ、III型母传抗体呈显著正相关关系(tII=5.953、P=0.000,tIII=7.260、P<0.001)。结论新生儿脊灰胎传抗体水平较母体下降。IPV全程接种、IPV与OPV序贯免疫对婴儿均有较好的免疫原性,中国现阶段可大力推进IPV与OPV序贯免疫程序。
Objective To evaluate the changes of polio neutralizing antibody in maternal and infant infants and to compare the changes of infant antibody levels under different immunization programs. Methods From July 2013 to April 2014, maternal and newborn babies delivered at Maternal and Child Health Hospital of Liwan District, Guangzhou City were selected as research objects. Serum epidemiological methods were used to analyze the prevalence of maternal and maternal 0 (newborns) The levels of neutralizing antibodies of poliovirus in 3 and 6 months old were analyzed. According to the infant basic immunization program, they were divided into live attenuated poliovirus (OPV) group, poliomyelitis inactivated vaccine (IPV) and IPV + OPV 3 Groups were compared for antibody levels after vaccination. Results A total of 179 maternal peripheral venous blood samples were collected. Blood samples were collected from 176,149,62 infants at 0, 3 and 6 months. Neonates had lower levels of neutralizing antibodies against poliovirus types I, II, and III than those of mothers. Antibody levels rose sharply at 3 and 6 months of age, up to 607.0 at 6 months (95% CI = 146.0-2 523.1 ), 239.6 (95% CI = 80.4-713.6) and 235.9 (95% CI = 56.0-994.8). There were no significant differences in the geometric mean titers of antibodies (P <0.05) between the geometric mean titers of antibodies of type I, II and III antibodies in OPV, IPV and IPV + OPV groups at various time points. There was a significant positive correlation between the level of poliovirus antibodies and neonatal poliovirus types II and III (tII = 5.953, P = 0.000, tIII = 7.260, P <0.001). Conclusion Neonatal polio fetus antibody levels decreased compared with maternal. IPV full vaccination, IPV and OPV sequential immunization of infants have better immunogenicity, China at this stage can vigorously promote IPV and OPV sequential immunization programs.