【摘要】：目的:通過開展百日咳、白喉胎傳抗體水平及陰轉(zhuǎn)率、抗體陽轉(zhuǎn)率、社區(qū)人群的抗體水平監(jiān)測,對濱海新區(qū)乃至我國百日咳再現(xiàn)背景下的百日咳、白喉的預(yù)防接種策略的調(diào)整提供科學依據(jù)。方法:隨機抽取132名新生兒,在出生時、滿3月齡未接種無細胞百白破疫苗(DTa P)時、滿6月齡即接種3劑次DTa P后1個月檢測百日咳和白喉Ig G抗體。采取分層隨機抽樣方法,從社區(qū)健康人群中抽取619人做為研究對象,抽取其靜脈血檢測百日咳和白喉Ig G抗體。采用酶聯(lián)免疫吸附試驗檢測百日咳Ig G抗體、白喉Ig G抗體。組間抗體陽性率的比較采用卡方檢驗。結(jié)果:1.新生兒百日咳胎傳抗體陽性率為31.06%,男女嬰間的差異無統(tǒng)計學意義;白喉胎傳抗體陽性率為33.33%,男嬰(38.16%)高于女嬰(26.79%)(P0.05)。2.胎傳抗體陽性新生兒滿3月齡未接種DTa P時,百日咳胎傳抗體陰轉(zhuǎn)率為89.19%,白喉胎傳抗體陰轉(zhuǎn)率為94.60%,差異無統(tǒng)計學意義;男、女嬰百日咳、白喉胎傳抗體陰轉(zhuǎn)率的差異均無統(tǒng)計學意義。3.新生兒滿6月齡即接種3劑次DTa P后1個月,百日咳抗體陽轉(zhuǎn)率為76.67%,白喉抗體陽轉(zhuǎn)率100.00%,差異有統(tǒng)計學意義。4.社區(qū)健康人群百日咳和白喉抗體陽性率分別為50.57%和60.90%,男女性陽性率的差異均無統(tǒng)計學意義。15歲人群百日咳抗體陽性率為36.77%,低于15~58歲人群的64.40%(P0.05)。15歲人群中,未免疫人群百日咳抗體陽性率為16.98%,有疫苗接種史者抗體陽性率為40.94%,差異有統(tǒng)計學意義;隨著免疫劑次增多百日咳抗體陽性率逐漸升高。而15歲人群白喉抗體陽性率為82.08%,高于15~58歲人群的40.45%,差異有統(tǒng)計學意義。15歲人群中,未免疫人群白喉抗體陽性率為35.85%,有疫苗接種史者抗體陽性率為91.34%,差異有統(tǒng)計學意義;隨著免疫劑次增多白喉抗體陽性率逐漸升高。15歲人群中接種過DTa P疫苗者的白喉抗體陽性率(91.34%)高于百日咳抗體陽性率(40.94%),差異有統(tǒng)計學意義。結(jié)論:新生兒百日咳、白喉的胎傳抗體陽性率低,有三分之二的新生兒無法獲得母體胎傳抗體的保護。3月齡時百日咳、白喉胎傳抗體幾乎完全轉(zhuǎn)陰,3月齡前嬰兒感染百日咳、白喉的風險高。DTa P基礎(chǔ)免疫后百日咳抗體陽轉(zhuǎn)率低于白喉抗體陽轉(zhuǎn)率。社區(qū)人群百日咳抗體陽性率較低,尤其在處于免疫規(guī)劃年齡的15歲以下人群。
[Abstract]:OBJECTIVE:To provide scientific basis for the adjustment of immunization strategy of pertussis and diphtheria in Binhai New Area and even in the background of pertussis recurrence in China by monitoring the levels and negative conversion rate of fetal borne antibodies to pertussis and diphtheria, positive conversion rate of antibodies, and antibody level of community population. The Ig G antibodies against pertussis and diphtheria were detected one month after three doses of DTa P were inoculated at the age of 6 months. A stratified random sampling method was used to detect the Ig G antibodies against pertussis and diphtheria in 619 healthy people in the community. Results: 1. The positive rate of fetal borne antibody in newborns with pertussis was 31.06%. There was no significant difference between male and female infants. The positive rate of fetal borne antibody in diphtheria was 33.33%. The positive rate of male infants (38.16%) was higher than that of female infants (26.79%) (P 0.05). There was no significant difference between male and female infants with pertussis or diphtheria. The positive rates of pertussis and diphtheria antibodies were 50.57% and 60.90% respectively in the healthy population of the community. There was no significant difference in the positive rates between men and women. The positive rate of diphtheria antibody in the 15-year-old group was 82.08%, which was higher than that in the 15-58-year-old group (40.45%). The difference was statistically significant. The positive rate of diphtheria antibody was 91.34%. The positive rate of diphtheria antibody was 91.34%. The positive rate of diphtheria antibody was 91.34% in the 15-year-old group who had been inoculated with DTap vaccine, which was higher than that of pertussis antibody (40.94%). Conclusion: There was a significant difference between the two groups. The positive rate of fetal transmission antibody was low, and two-thirds of the newborns could not get the protection of maternal transmission antibody. The positive rate was low, especially in those below 15 years of age.
【學位授予單位】：天津醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R181.3;R516.6;R517.1

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