發(fā)布時間：2019-06-03 04:50

【摘要】：背景 2007年,我國實(shí)施擴(kuò)大的免疫規(guī)劃,在原有的“6種疫苗預(yù)防7種傳染病”的基礎(chǔ)上,新增加了麻疹-風(fēng)疹聯(lián)合減毒活疫苗(Measles-rubella Combined Attenualed Live Vaccine, MR)、麻疹-流行性腮腺炎-風(fēng)疹聯(lián)合減毒活疫苗(Measles, Mumps and Rubella Combined Attenualed Live Vaccine, MMR)等,預(yù)防傳染病的種類也隨之增加。其中,MR聯(lián)合減毒活疫苗在兒童8月齡接種,MMR聯(lián)合減毒活疫苗在兒童18-24月齡接種。為了進(jìn)一步了解MR聯(lián)合減毒活疫苗和MMR聯(lián)合減毒活疫苗在兒童8月齡起初始免疫安全性及免疫學(xué)效果,對該兩種疫苗做進(jìn)一步觀察。 目的 觀察MR聯(lián)合減毒活疫苗、MMR聯(lián)合減毒活疫苗兒童初始免疫安全性及免疫學(xué)效果,為國家免疫規(guī)劃疫苗免疫程序的應(yīng)用提供直接的基礎(chǔ)數(shù)據(jù)。 方法 根據(jù)研究需要,選擇8-18月齡未接種過含麻疹、風(fēng)疹和腮腺炎成分疫苗,并未患過出疹性疾病和腮腺炎的兒童,分為MR聯(lián)合減毒活疫苗組、MMR聯(lián)合減毒活疫苗組,對兒童進(jìn)行個案調(diào)查,同時利用常規(guī)免疫接種的機(jī)會,在上臂三角肌皮下接種MR聯(lián)合減毒活疫苗組或MMR聯(lián)合減毒活疫苗組,分別在接種疫苗前和接種疫苗一個月后采集兒童免疫前、后血標(biāo)本。在接種疫苗后30分鐘內(nèi)、3天、7天和第二次采血時觀察不良反應(yīng)發(fā)生情況。采集的血標(biāo)本經(jīng)過離心后,對免疫前、后血清采用酶聯(lián)免疫吸附試驗(yàn)(Enzyme Linked Immunosorbent Assays, ELISA)方法檢測麻疹、風(fēng)疹、腮腺炎IgG抗體,分析兩種疫苗接種后疫苗相應(yīng)成分抗體陽轉(zhuǎn)情況。同時,在接種疫苗后對兒童進(jìn)行隨訪,觀察疫苗接種后不良反應(yīng)發(fā)生情況。 麻疹、風(fēng)疹、腮腺炎抗體分別選用德國“維潤賽潤”麻疹、風(fēng)疹和腮腺炎IgG抗體檢測試劑盒。結(jié)果判斷標(biāo)準(zhǔn)：麻疹I(lǐng)gG抗體≥150mIU/ml(毫國際單位/毫升)為陽性、＜150mIU/ml為陰性；風(fēng)疹I(lǐng)gG抗體≥10IU/ml(國際單位/毫升)為陽性、10IU/ml為陰性；腮腺炎IgG抗體≥70U/ml(單位/毫升)為陽性、70U/ml為陰性。不良反應(yīng)觀察觀察標(biāo)準(zhǔn)見附錄5。 結(jié)果 MR聯(lián)合減毒活疫苗組：接種疫苗前采集血標(biāo)本兒童140名,接種疫苗前麻疹抗體陽性率1.43%、風(fēng)疹抗體陽性率17.14%；疫苗接種后采集血標(biāo)本兒童118名,麻疹抗體陽性率94.92%、風(fēng)疹抗體陽性率72.03%；麻疹抗體陽轉(zhuǎn)率94.83%、風(fēng)疹抗體陽轉(zhuǎn)率73.47%；該組不良反應(yīng)發(fā)生率7.14%。 MMR組：疫苗接種前采集血標(biāo)本兒童143名,疫苗接種前麻疹抗體陽性率13.29%、風(fēng)疹抗體陽性率14.68%、腮腺炎抗體陽轉(zhuǎn)率17.48%；疫苗接種后采集血標(biāo)本兒童139名,麻疹抗體陽性率99.28%、風(fēng)疹抗體陽性率84.89%、腮腺炎抗體陽性率67.62%；麻疹抗體陽轉(zhuǎn)率99.18%、風(fēng)疹抗體陽轉(zhuǎn)率84.03%、腮腺炎抗體陽轉(zhuǎn)率68.96%；該組不良反應(yīng)發(fā)生率6.63%。 結(jié)論 MR聯(lián)合減毒活疫苗麻疹成分具有良好的免疫原性。風(fēng)疹成分抗體陽轉(zhuǎn)率較低,尚需進(jìn)一步研究。接種MR聯(lián)合減毒活疫苗未發(fā)現(xiàn)嚴(yán)重不良反應(yīng),相對安全。 MMR聯(lián)合減毒活疫苗麻疹成分具有良好的免疫原性。風(fēng)疹、腮腺炎成分陽轉(zhuǎn)率較低,尚需進(jìn)一步研究。接種MMR聯(lián)合減毒活疫苗未發(fā)現(xiàn)嚴(yán)重不良反應(yīng),相對安全。
[Abstract]:background In 2007, our country implemented the expanded immunization program, on the basis of the original "Six vaccines for the prevention of 7 infectious diseases", a new combination of measles-rubella combined and attenuated live vaccine (MR), measles-mumps-rubella combined and attenuated live vaccine (Measles, Mumps and Rubella combined attached Live Vaccin) was added. e, MMR) and the like, and the types of prevention of infectious diseases also increase wherein, the MR combined attenuated live vaccine is inoculated at the age of 8 months, and the MMR and the attenuated live vaccine are taken at the age of 18 to 24 months of the child in ord to further understand that initial immunization safety and the immunological effect of the combined attenuated live vaccine and the MMR vaccine in the age of 8 months of the child, the two vaccines are further A. Objective To observe the initial immunization safety and immunological effect of the combined attenuated live attenuated live vaccine (MMR) and the attenuated live attenuated live vaccine (MMR) in children, and provide a direct and direct method for the application of the vaccine to the national immunization program. basis The method comprises the following steps of: selecting a vaccine containing measles, rubella and mumps in 8-18 months of age according to the needs of the research, and is not affected by the measles, rubella and mumps, and is divided into a combination of the MR and the attenuated live vaccine, the MMR and the attenuated live vaccine group, A case-by-case study was conducted on children, with the opportunity to use conventional immunizations, and a combination of a combination of an attenuated live vaccine or a combination of MMR and an attenuated live vaccine was administered subcutaneously in the upper arm's deltoid muscle, which was collected one month before and after the vaccination. Blood samples before and after immunization,3 days,7 days, and second time of blood collection within 30 minutes of the administration of the vaccine An enzyme-linked immunosorbent assay (ELISA) was used to detect the measles, rubella and mumps IgG antibody, and the vaccine phase after vaccination was analyzed by enzyme-linked immunosorbent assay (ELISA). In addition, after vaccination, the child will be followed up to observe the vaccination The following adverse reactions occurred: Measles, rubella, and mumps were selected from German "Wei Runrun" measles, rubella and parotid. The test kit for the detection of the anti-inflammatory IgG antibody. The result is as follows: the measles IgG antibody is positive for 150 mIU/ ml (mIU/ ml), less than 150 mIU/ ml is negative, the rubella IgG antibody is 10 IU/ ml (the international unit/ ml) is positive,10 IU/ ml is negative, and the mumps IgG antibody is 70U/ ml (unit/ ml) as the male. Sex,70 U/ ml is negative. Adverse reaction view of view Results: The positive rate of measles antibody was 1.43%, the positive rate of rubella antibody was 17.14%, and the positive rate of measles antibody was 94.92. The positive rate of rubella antibody was 72.03%, the positive rate of measles antibody was 94.83%, and the positive rate of rubella antibody was 73.47%. The incidence of the group was 7.14%. MMR group:143 children were collected before the vaccination, the positive rate of the measles antibody was 13.29%, the positive rate of the rubella antibody was 14.68%, the positive rate of the mumps antibody was 17.48%, and the positive rate of the measles antibody was 99. The positive rate of the rubella antibody was 84.89%, the positive rate of the mumps antibody was 67.62%, the positive rate of the measles antibody was 99.18%, the positive rate of the rubella antibody was 84.03%, and the seroconversion rate of the mumps antibody was 68.9%. 6% ; the incidence of adverse reactions in the group was 6.63%. Conclusion M the measles component of the R joint attenuated live vaccine has good immunogen, The positive rate of the antibody of rubella is lower, and it is necessary to further study. The combined attenuated live vaccine did not find serious adverse reactions and was relatively safe. The measles component of the MMR vaccine combined with the attenuated live vaccine has good immunogen Sex. Rubella and mumps are low in positive rate and need to be further studied. Inoculated M
【學(xué)位授予單位】：中國疾病預(yù)防控制中心
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2010
【分類號】：R186

【參考文獻(xiàn)】

相關(guān)期刊論文 前10條

1 黃長江,王尚舜;國產(chǎn)凍干麻疹-風(fēng)疹二聯(lián)活疫苗臨床安全性研究[J];安徽預(yù)防醫(yī)學(xué)雜志;2000年04期

2 梁勇;;麻疹疫苗免疫效果及其影響因素研究進(jìn)展[J];傳染病信息;2001年01期

3 劉新梅;黃江河;劉冬梅;;2005～2006年克拉瑪依市健康人群風(fēng)疹抗體水平分析[J];地方病通報(bào);2008年03期

4 陳健,梁建華,金順英,李志群,王鳴;廣州市兒童麻疹疫苗免疫效果評價(jià)及初免月齡探討[J];華南預(yù)防醫(yī)學(xué);2005年03期

5 劉淑勤,黃躍紅,陳秀芬;不同毒株制備的腮腺炎疫苗的免疫效果分析[J];華南預(yù)防醫(yī)學(xué);2005年03期

6 陳靜靜;徐永范;;奉化市麻疹免疫成功率和學(xué)生麻疹I(lǐng)gG抗體水平分析[J];現(xiàn)代實(shí)用醫(yī)學(xué);2008年05期

7 譚文文;陳志敏;史麗敏;王莉;周建剛;;宜興市麻疹疫苗免疫成功率監(jiān)測結(jié)果分析[J];上海預(yù)防醫(yī)學(xué)雜志;2008年06期

8 徐福根,陳康凱,黃誠孝,李勵,蔣金香,祝水芬,許二萍,黃利明,姚懷芳,孫木興,朱建慧;風(fēng)疹和麻疹疫苗同時或分別接種的免疫效果[J];中國生物制品學(xué)雜志;1997年03期

9 徐宏基;李微;夏建華;陶紅;方捍華;李亞君;儲艷;馬富寶;徐聞青;王樹巧;;國產(chǎn)凍干麻疹腮腺炎風(fēng)疹聯(lián)合減毒活疫苗的接種反應(yīng)和免疫原性觀察[J];中國生物制品學(xué)雜志;2008年12期

10 武濱;俞愛琴;李晉玲;蔡日恩;張保安;余曉瓊;;麻疹-腮腺炎-風(fēng)疹三聯(lián)疫苗擴(kuò)大免疫安全性及免疫效果研究[J];山西醫(yī)藥雜志;2009年03期

，

本文編號：2491681