2018年成都市健康人群破伤风抗体水平监测结果分析

目的分析成都市健康人群破伤风抗体水平情况,评价含破伤风类毒素疫苗免疫效果,为优化免疫策略提供依据。方法 2018年抽取成都市一、二、三圈层5个区(市)县,共调查1 105名健康人群人口和疫苗接种信息,采集血清标本进行破伤风IgG检测。采用χ~2检验和秩和检验对数据进行分析。结果健康人群总破伤风抗体浓度M为0.34 IU/ml,达到充分免疫或长期保护水平(>0.1 IU/ml)的率为68.60%。5个地区破伤风抗体浓度M在0.270 IU/ml^0.415 IU/ml之间(H=21.392,P<0.01),抗体浓度达到充分免疫或长期保护水平的率在63.96%~75.41%之间(χ~2=104.402,P<0.01);各年龄组破伤风抗体浓度M在0.030 IU/ml^0.955 IU/ml之间(H=599.017,P<0.01),抗体浓度达到充分免疫或长期保护水平的率在14.29%~95.83%之间(χ~2=690.965,P<0.001);男性破伤风抗体浓度(0.415 IU/ml)比女性(0.280 IU/ml)高(Z=-3.069,P=0.002)、男性(73.33%)抗体浓度达到充分免疫或长期保护水平的率也高于女性(64.96%)(χ~2=8.876,P=0.012)。结论需进一步加强中心城区流动儿童及郊区预防接种管理工作,建议在成年人群中引入第6剂次含破伤风类毒素疫苗的加强免疫。

Serological Surveillance of Tetanus Antibody Level Among Healthy People of Chengdu in 2018

Objective To investigate the level of tetanus antibody among healthy people in Chengdu in 2018 and evaluate the immune effect of tetanus toxoid vaccine, so as to provide reference for improving the immunization strategy against tetanus. Methods In 2018,the study selected 5 districts(cities)/counties from three layers in Chengdu. Demographic information and immunization records of 1 105 healthy people were surveyed,and the serum specimen was collected for the detection of IgG for tetanus toxin. Chi square test and rank-sum test were used to analyze the data. Results the total median antibody concentration against tetanus was 0.34 IU/ml,with 68.60% reaching full immunization or long-term protection level(>0.1 IU/ml). The area-specific median antibody concentrations ranged from 0.270 IU/ml to 0.415 IU/ml(H=21.392, P<0.01), with the positive rates(>0.1 IU/ml) ranged from 63.96% to 75.41% (χ~2=104.402,P<0.01). The age-specific median antibody concentrations ranged from 0.030 IU/ml to 0.955 IU/ml(H=599.017, P<0.01),their positive rates ranged from 14.29% to 95.83% (χ~2=690.965, P<0.01). The median antibody concentration of male(0.415 IU/ml) was higher than female(0.280 IU/ml)(Z=-3.069, P=0.002), the gender difference also existed in the positive rate,which of male(73.33%) was also higher than that of female(64.96%)(χ~2=8.876,P=0.012). Conclusion The immunization management of floating children in the urban areas and suburban areas should be further strengthened. The supplementary immunization with the sixth dose tetanus toxin containing vaccine in adults could improve immunity.