深圳市罗湖区109对母婴配对麻疹母传抗体水平研究

目的 了解孕妇及其新生儿麻疹抗体水平,探讨新生儿与孕母麻疹抗体平的关系以及新生儿抗体随时间变化的规律,为控制小月龄儿童发病提供建议。方法 2013年-2015年间,采集罗湖区109名孕妇产前静脉血及其新生儿脐带血、新生儿3月龄87例、5月龄79例、7月龄63例静脉血,使用ELISA方法进行麻疹IgG检测,用卡方检验进行率的比较,方差分析、t检验用于对数抗体浓度的比较。结果 新生儿麻疹抗体几何平均浓度（GMC）1001.39mIU/ml,是母血抗体浓度（646.28mIU/ml）的1.55倍（t_配对=9.368,P<0.001）。3月龄、5月龄、7月龄时麻疹抗体几何平均浓度（GMC）分别下降到161.63mIU/ml、125.61mIU/ml、112.91mIU/ml。母血抗体阳性率（85.3%）和保护率（45.0%）均低于脐带血（χ²=39.176,P<0.001; χ²=35.821,P<0.001）,出生后抗体阳性率和保护率均逐月下降（趋势检验,χ²_阳性率=115.618, P<0.001;χ²_保护率=109.441, P<0.001）。64.22%的对子,母血和脐血抗体在同一浓度水平。母血抗体对数浓度和脐带血、3、5、7月龄血抗体对数浓度均呈正相关（r₁=0.897, t=20.942,P<0.001; r₂=0.768, t=11.045, P<0.001; r₃=0.574, t=6.154, P<0.001; r₄=0.257, t=2.074, P=0.042）。结论 新生儿出生后麻疹抗体衰减,而母亲抗体水平决定着新生儿的抗体水平,当前开展针对育龄妇女的麻疹疫苗接种,通过提高母亲抗体水平继而提高新生儿麻疹抗体水平,是控制小月龄婴儿罹患麻疹的重要途径。

study on the maternal delivered measles antibody in 109 maternal infant pairs in Luohu district Shenzhen

Objective To know the levels and relationship of measles antibody in newborns with their mothers, and the duration of maternal delivered measles antibodies in infants. Methods a total of 109 mother newborn pairs’ serum sample and 87 three month, 79 five month, 63 seven month infants’ serum samples were collected in Luohu to test the measles antibody level with ELISA. Results the geometric mean concentration (GMC) of maternal measles antibody was 646.28mIU/ml, and GMC of neonatal measles antibody was 1001.39mIU/ml , which was 1.55 times more than the geometric mean concentration of maternal measles antibody（paired t =9.368,P<0.001); the GMC decreased to 161.63mIU/ml,125.61mIU/ml and 112.91mIU/ml in 3,5 and 7 month infants respectively. Both positive rate and protective rate of measles antibodies were significantly lower in mothers than in newborns, ( χ²=39.176,P<0.001; χ²=35.821,P<0.001). and decreased monthly after birth(χ²_positive=115.618, P<0.001;χ²_protective=109.441, P<0.001). 64.22% of all pairs shared the same degree of antibody level. Maternal logarithmic concentration of measles antibody was positively correlated with logarithmic concentration of newborns, 3, 5 and 7 month babies,the coefficients of correlation were 0.897, 0.768, 0.574, 0.257 respectively. Conclusion maternal measles antibody level was the key factor affecting newborn’s antibody level; enhancing measles vaccine immunization for women of child-bearing age is an important method to control the onset of measles in infants.