狂犬病疫苗接种者的免疫效果分析

目的]了解狂犬病暴露者接种狂犬病疫苗后的免疫效果,探讨预防策略。方法]观察疫苗使用者的反应情况,随机抽取624例狂犬病暴露者接种狂犬病疫苗5针(0、3、7、14、28d)后10～20d采集静脉血,采用间接酶联免疫吸附试验(ELISA)测定狂犬病毒(RV)IgG抗体。结果]报告接种反应发生率为9.35/万,无严重不良反应;624例暴露者接种疫苗后RV-IgG抗体阳性594人,平均阳性率95.19%;男、女暴露者RV-IgG抗体阳性率差异无统计学意义(χ2=0.719,P﹥0.05);﹤15岁人群抗体阳性率最高100%,﹥65岁率最低为90.48%,随年龄增大抗体阳性率呈下降趋势,各年龄组间抗体阳性率差异有统计学意义(χ2=19.146,P﹤0.01);大连金港安迪、辽宁依生、辽宁成大、宁波荣安、武汉5家生物所的疫苗抗体阳性率之间差异无统计学意义(χ2=8.638,P﹥0.01),但均高于长春生物所χ2=95.446,P﹤0.01);大连金港安迪、辽宁成大、宁波荣安3所各批号疫苗抗体阳性率差异无统计学意义(χ2=1.02、1.26、0.22,P均﹥0.05)。结论]国产狂犬病疫苗免疫效果好;年龄小者免疫效果优于年长者;除个别外多数厂家疫苗免疫效果差异不大;暴露后使用国产疫苗能够起到预防狂犬病作用。

ANALYSIS OF THE IMMUNE EFFECTIVENESS OF RABIES VACCINE

Objective]To understand the immune effectiveness for rabies virus(RV)exposed persons after vaccinated with rabies vaccine,to find out its preventive strategies.Methods]The adverse reactions of rabies vaccine were observed,and the venous bloods from random sampling 624 RV-exposed persons were collected during 10-20 days after finished 5 doses of serial vaccination with rabies vaccines at the 1st,3rd,7th,14th and 28th day,and to test RV IgG antibodies with indirect enzyme-linked immunosorbent assay(ELISA).Results]The reported incidence rate of the adverse reactions for rabies vaccine was 9.35 per 10 thousand,with no severe adverse reaction occurred.594 of 624 RV exposed persons after vaccinated with rabies vaccine had positive RV IgG antibodies,and the average positive rate was 95.19%,with not statistic significance in positive RV antibody rate between male and female exposed persons(χ2 = 0.719,P﹥0.05).The positive rate were the highest(100%)among the exposed persons aged under 15 years old and the lowest(90.48%)among the exposed persons aged more than 65 years old,with a descending trend with increase of ages;The positive rate had not markedly statistic significance between age groups(χ2 = 19.146,P﹤0.01),and also not statistic differences between the different rabies vaccines produced by Dalian JGAD Bio-products,Niaoning Yisheng,Niaoning Chengda Biotechnology,Ningbo Rongan and Wuhan Institute of Biologic Products(χ2 = 8.638,P﹥0.01),but was higher than the rabies vaccine produced by Changchun Institute of Biologic Products(χ2 = 95.446,P﹤0.01).There was not statistic significance in the positive rate for different batches of the rabies vaccines from Dalian JGAD Bio-products,Niaoning Chengda Biotechnology and Ningbo Rongan(χ2 = 1.02,1.26 and 0.22,P﹥0.05,respectively).Conclusion]China-made rabies vaccines have good immune effectiveness,and the immune effectiveness among younger groups are better than that among older groups.The effectiveness of rabies vaccines from most of vaccine manufacturers don’t exist significant difference;post-exposure vaccination of homemade rabies vaccine can play a role of prevention of rabies.