2014-2018年天津市南开区疑似麻疹病例血清学和病毒核酸检测结果分析

目的 对2014-2018年天津市南开区疑似麻疹病例的实验室检测结果进行分析,为麻疹的预防控制和早期诊断提供科学依据。方法 采集疑似麻疹病例血清和咽拭子样本,分别采用ELISA法和Real-time RT-PCR法进行检测。结果 共检测776例疑似麻疹病例,检出麻疹阳性428例,阳性率55.15%。2016年麻疹阳性率最高,为72.87%,高于其他年份(P＜0.05)。麻疹的性别分布无差异;麻疹阳性率以＜8月龄组最高,为78.57%,不同年龄组麻疹阳性率差异有统计学意义(P＜0.001);麻疹多集中在1~5月份。出疹后0~3天采集的咽拭子核酸阳性率最高,为54.93%,高于其他组(P＜0.05)。有明确麻疹免疫史的疑似麻疹病例麻疹阳性率低于无麻疹免疫史和免疫史不详的病例。ELISA法和Real-time RT-PCR法检测麻疹结果的差异无统计学意义(P=0.422)。结论 继续做好麻疹常规免疫,开展重点人群的补充免疫工作;控制医院内感染,防止就医感染麻疹;保证样本质量,提高实验室确诊率。

Results of serological and viral nucleic acid detection of suspected measles cases in Nankai District of Tianjin, 2014-2018

Objective To analyze laboratory testing results of suspected measles cases in Tianjin Nankai from 2014 to 2018, so as to provide scientific basic for prevention control and early diagnosis of measles. Methods The serum and pharynx swabs samples of suspected measles cases were collected and detected by ELISA and Real-time RT-PCR. Results The 776 suspected measles cases were detected, 428 cases were positive for measles, with the positive rate of 55.15 %. The highest positive rate of measles in 2016 was 72.87 %, which was higher than that of other years(P<0.05). There was no difference in the gender distribution of measles. The highest positive rate of measles was 78.57% in the group of <8 months old and there was a significant difference in the positive rate of measles among different age groups(P<0.001). Measles was mostly concentrated in January-May. The positive rate of nucleic acid in pharynx swabs collected 0～3 days after exanthema was the highest(54.93%), which was higher than that of other groups(P<0.05). The measles positive rate of suspected measles cases with clear history of immunization was significantly lower than those without and unknown history of immunization. There was no significant difference between ELISA and Real-time RT-PCR in the detection of measles. Conclusion Continue routine measles immunization and supplementary immunization work for key populations should be carry on. It is also essential to control nosocomial infection,prevent measles infection in hospital, ensure sample quality and improve laboratory diagnosis rate.