江蘇省部分地區(qū)兒童流感嗜血桿菌感染及抗體水平調查
發(fā)布時間：2019-06-03 03:56
【摘要】： 流感嗜血桿菌(Haemophilus influenzae，Hi)，是目前兒童細菌性感染的主要病原體之一，有近30％的急性下呼吸道感染由Hi感染所致，b型占絕大多數(shù)。過去60年中，很多國家已從多方面開展了對Hib的研究。上世紀80年代起，Hib結合疫苗開始廣泛應用，30年間取得了很好的預防效果。到2004年底已有94個國家將Hib結合疫苗納入了國家計劃免疫，而和許多發(fā)展中國家一樣，我國未將其列入其中，原因之一就是對Hi感染缺乏有效監(jiān)測，對其引起的感染性疾病的認識還不夠充分和深入。本課題以江蘇省部分地區(qū)(濱海、丹陽、楚州)為現(xiàn)場，在健康兒童中開展流感嗜血桿菌的流行病學研究。 第一部分江蘇省部分地區(qū)兒童抗b型流感嗜血桿菌多糖抗體水平調查 人群中抗體水平的高低直接影響疾病的發(fā)病，不同國家、地區(qū)、種族和年齡層的人群有不同的抗體水平，故了解江蘇部分地區(qū)健康兒童抗b型流感嗜血桿菌多糖抗體水平對該地區(qū)疫苗的合理使用可提供基礎資料和科學依據。本研究采用酶聯(lián)免疫吸附試驗(ELISA)對健康兒童血清中的Hib-PRP自然抗體水平進行檢測。主要結果如下： 1．總體抗Hib-PRP抗體水平 血清抗Hib-PRP抗體水平≥0.15μg／mL時視為陽性，三地兒童血清Hib-PRP抗體總體陽性率為60.81％(869／1429)。Hib-PRP抗體幾何平均滴定度(GMT)為0.60μg／mL。 2．不同地區(qū)兒童抗Hib-PRP抗體水平 濱海，丹陽，楚州三地的保護性陽性率分別為46.64％，66.14％及72.44％；楚州和丹陽地區(qū)陽性率無顯著性差異(X~2=2.50，P=0.066)，楚州和濱海，丹陽和濱海地區(qū)陽性率差異則有統(tǒng)計學意義(X~2=50.01，，P＜0.001；=30.70，P＜0.001)。 3．不同年齡段兒童抗Hib-PRP抗體水平 抗體水平與年齡有很密切的關系，臍帶血抗體含量較高，濱海、楚州、丹陽三地分別為0.72μg／mL，1.39μg／mL，1.13μg／mL，隨后下降，4-6月齡時降到最低點，隨著年齡的增長，抗體水平又逐漸上升。丹陽，楚州地區(qū)上升幅度較大，5歲后均大于1μg／mL，濱海地區(qū)抗體水平較前兩個地區(qū)低，但也有明顯增高。 第二部分江蘇省部分地區(qū)健康兒童流感嗜血桿菌帶菌率調查 流感嗜血桿菌是人體鼻咽、口咽部常見的定殖菌，健康人群的自然攜帶是Hi引起侵襲性疾病的重要原因。本研究結合細菌培養(yǎng)和PCR檢測方法，在春季檢測江蘇部分地區(qū)(濱海、丹陽)健康兒童的帶菌情況，為臨床防治提供參考。結果如下： 1．1歲以內每兩個月劃分為一組，1歲之后則以一年為一組，各組的Hi攜帶率分別為55.65％、53.76％、66.02％、54.88％、62.12％、59.15％、63.24％、61.54％、63.33％、50.56％，其中5～6月齡的攜帶率為最高。 2．各年齡組抗體陽性率隨著年齡先下降，后上升，在3～4月齡時為最低，1歲之后，抗體水平陽性率均在50％以上。 3．Hi攜帶率在男女兒童之間差異無統(tǒng)計學意義。 第三部分江蘇省南京市b型流感嗜血桿菌細菌性腦膜炎病例監(jiān)測 目前包括我國在內的大部分發(fā)展中國家尚未將Hib結合疫苗納入國家擴大的計劃免疫，很大一部分原因是缺乏該病詳盡資料，尤其是準確的發(fā)病率和疾病負擔評價資料。我國僅有楊永弘等1990-1992年在合肥開展過Hib發(fā)病率的研究。 自2006年12月至2008年12月，中國疾病預防控制中心在江蘇省南京市開展細菌型腦膜炎病例的監(jiān)測。結果顯示：2006年12月至2007年4月南京市共有細菌性腦膜炎患者10例，其中1例為Hib病例，占細菌性腦膜炎的10％。此項工作仍在行進中。
[Abstract]:Haemophilus influenzae (Hi) is one of the main pathogens of bacterial infection in children. In the last 60 years, the study of Hib has been carried out in many countries. Since the 1980s, Hib has been widely used in combination with the vaccine, and a good preventive effect has been achieved in the past 30 years. By the end of 2004,94 countries have included Hib-bound vaccines in national plans, as in many developing countries, one of which is the lack of effective monitoring of the Hi-infection and the insufficient and in-depth understanding of the infectious diseases that it causes. The epidemiological study of Haemophilus influenzae was carried out in healthy children by taking part of Jiangsu Province (Binhai, Danyang, and Chuzhou) as the site. Anti-b-type Haemophilus influenzae in some parts of Jiangsu Province The level of the antibody in the level of the sugar antibody directly affects the incidence of the disease, different countries, regions, races and years. The anti-b-type Haemophilus influenzae polysaccharide antibody level of the healthy children in some parts of Jiangsu Province is reasonable for the vaccine in the region, according to the different antibody levels of the population of the aging layer. The basic data and scientific basis can be provided. The present study uses an enzyme-linked immunosorbent assay (ELISA) to treat Hib in healthy children's serum. PRP natural antibody The level is tested. The main results are as follows: 1. The overall anti-Hib-PRP antibody level was considered positive when the level of the anti-Hib-PRP antibody was 0.15. m u.g/ mL, and the serum Hib-PRP antibody in the three children was considered positive. The overall positive rate of PRP was 60.81% (869/1429). Hib- The geometric mean titer (GMT) of the PRP antibody is 0. The protective positive rates of the anti-Hib-PRP antibody in different areas were 46.64%, 66.14% and 72.44%, respectively. There was no significant difference in the positive rate of positive rate in the region of Chuzhou and Danyang (X ~ 2 = 2.50, P = 0.066), and the positive rate of positive rate in Chuzhou and Binhai, Danyang and Binhai region. Statistical significance (X ~ 2 = 50.01, P <0 (.001; = 30.70, P <0.001).3. The level of anti-Hib-PRP antibody in children of different age groups has a close relationship with the age, and the content of the cord blood antibody is high, the coastal and the Chu 0.72 & mu; g/ mL in the state and Danyang, respectively 1.39. m u.g/ mL, 1.13. mu.g/ mL, followed by a decrease, to the lowest point at 4-6 months of age, with the increase in age, the level of antibody As a result, the rise in the area of Danyang and Chuzhou is large, and after the age of 5, it is more than 1. The level of antibody in the coastal area was lower than that in the first two areas, but it also increased significantly. The second part of Jiangsu Province Haemophilus influenzae (H. influenzae) with H. influenzae (H. H.) and H. influenzae (Haemophilus influenzae) are the common pathogenic bacteria in the nasopharynx and oropharynx of the human body, and the natural carrying of the healthy population is H. i. Invasiveness The results of this study, combined with the methods of bacterial culture and PCR, were used to detect the condition of the band of the healthy children in some parts of Jiangsu province (Binhai and Danyang) in spring. The results are as follows:1.1 year old is divided into one group, one year after one year, and the Hi-carrying rate of each group is 55.65%,5. 3.76%, 66.02%, 54.88%, 62.12%, 59.15%, 63.24%, 61.54%, 63.33% And the carrying rate of 5 to 6 months is the highest. 2. The positive rate of antibody in all age groups decreased with age, then The positive rate of the antibody was more than 50% at the age of 3 to 4 months and the positive rate of the antibody was more than 50% after the age of 1. No statistical significance. The third part of the river Surveillance of the bacterial meningitis in the b-type Haemophilus influenzae in Nanjing, Jiangsu Province Most of the developing countries, including my country, have not included Hib-bound vaccines in the country's expanded plan for immunization, a large part of which is due to the lack of detailed information on the disease Materials, especially the accurate incidence and disease burden evaluation data, are only the study of the incidence of Hib in Hefei from 1990 to 1992, such as Yang Yonghong and the like. Since December 2006
【學位授予單位】：南京醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2007
【分類號】：R181.3
本文編號：2491647
[Abstract]:Haemophilus influenzae (Hi) is one of the main pathogens of bacterial infection in children. In the last 60 years, the study of Hib has been carried out in many countries. Since the 1980s, Hib has been widely used in combination with the vaccine, and a good preventive effect has been achieved in the past 30 years. By the end of 2004,94 countries have included Hib-bound vaccines in national plans, as in many developing countries, one of which is the lack of effective monitoring of the Hi-infection and the insufficient and in-depth understanding of the infectious diseases that it causes. The epidemiological study of Haemophilus influenzae was carried out in healthy children by taking part of Jiangsu Province (Binhai, Danyang, and Chuzhou) as the site. Anti-b-type Haemophilus influenzae in some parts of Jiangsu Province The level of the antibody in the level of the sugar antibody directly affects the incidence of the disease, different countries, regions, races and years. The anti-b-type Haemophilus influenzae polysaccharide antibody level of the healthy children in some parts of Jiangsu Province is reasonable for the vaccine in the region, according to the different antibody levels of the population of the aging layer. The basic data and scientific basis can be provided. The present study uses an enzyme-linked immunosorbent assay (ELISA) to treat Hib in healthy children's serum. PRP natural antibody The level is tested. The main results are as follows: 1. The overall anti-Hib-PRP antibody level was considered positive when the level of the anti-Hib-PRP antibody was 0.15. m u.g/ mL, and the serum Hib-PRP antibody in the three children was considered positive. The overall positive rate of PRP was 60.81% (869/1429). Hib- The geometric mean titer (GMT) of the PRP antibody is 0. The protective positive rates of the anti-Hib-PRP antibody in different areas were 46.64%, 66.14% and 72.44%, respectively. There was no significant difference in the positive rate of positive rate in the region of Chuzhou and Danyang (X ~ 2 = 2.50, P = 0.066), and the positive rate of positive rate in Chuzhou and Binhai, Danyang and Binhai region. Statistical significance (X ~ 2 = 50.01, P <0 (.001; = 30.70, P <0.001).3. The level of anti-Hib-PRP antibody in children of different age groups has a close relationship with the age, and the content of the cord blood antibody is high, the coastal and the Chu 0.72 & mu; g/ mL in the state and Danyang, respectively 1.39. m u.g/ mL, 1.13. mu.g/ mL, followed by a decrease, to the lowest point at 4-6 months of age, with the increase in age, the level of antibody As a result, the rise in the area of Danyang and Chuzhou is large, and after the age of 5, it is more than 1. The level of antibody in the coastal area was lower than that in the first two areas, but it also increased significantly. The second part of Jiangsu Province Haemophilus influenzae (H. influenzae) with H. influenzae (H. H.) and H. influenzae (Haemophilus influenzae) are the common pathogenic bacteria in the nasopharynx and oropharynx of the human body, and the natural carrying of the healthy population is H. i. Invasiveness The results of this study, combined with the methods of bacterial culture and PCR, were used to detect the condition of the band of the healthy children in some parts of Jiangsu province (Binhai and Danyang) in spring. The results are as follows:1.1 year old is divided into one group, one year after one year, and the Hi-carrying rate of each group is 55.65%,5. 3.76%, 66.02%, 54.88%, 62.12%, 59.15%, 63.24%, 61.54%, 63.33% And the carrying rate of 5 to 6 months is the highest. 2. The positive rate of antibody in all age groups decreased with age, then The positive rate of the antibody was more than 50% at the age of 3 to 4 months and the positive rate of the antibody was more than 50% after the age of 1. No statistical significance. The third part of the river Surveillance of the bacterial meningitis in the b-type Haemophilus influenzae in Nanjing, Jiangsu Province Most of the developing countries, including my country, have not included Hib-bound vaccines in the country's expanded plan for immunization, a large part of which is due to the lack of detailed information on the disease Materials, especially the accurate incidence and disease burden evaluation data, are only the study of the incidence of Hib in Hefei from 1990 to 1992, such as Yang Yonghong and the like. Since December 2006
【學位授予單位】：南京醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2007
【分類號】：R181.3
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