育龄妇女接种麻疹疫苗对婴儿麻疹发病影响的研究

目的研究育龄妇女接种麻疹疫苗（measles attenuated live vaccine,MV）对婴儿麻疹发病的影响,为降低婴儿麻疹发病提供参考。方法分析2006-2012年枣庄地区婴儿麻疹发病状况,采用酶联免疫吸附试验,检测育龄妇女接种MV后母婴麻疹抗体。用SPSS 11.5软件进行统计分析,分析方法运用χ2检验、t检验、F检验,以P〈0.05为差异有统计学意义。结果育龄妇女接种MV后（2010-2012年）婴儿年均麻疹发病率降至34.08/10万;病例以母亲孕前≥24个月接种MV者最高,占婴儿病例的50.00%（19/38）,其中〈8月龄占42.11%（16/38）;育龄妇女抗体阳性率、几何平均倒数滴度（GMRT）分别为95.72%和1 300.52,随时间推移到孕前24个月迅速下降至82.05%和521.35,接近免前水平（82.72%、419.78）。孕前3-6个月、8-12个月内接种,其婴儿（0-8月龄）麻疹抗体阳性率、GMRT明显高于相应对照（χ^2=27.92、24.41;t=10.23、9.78;均P〈0.01）,而其8月龄婴儿免疫成功率（76.19%-90.00%）、GMRT（672.24-712.56）差异均无统计学意义（χ^2=1.54,F=0.47,P〉0.05）。结论育龄妇女孕前3-12个月内接种MV,可显著提高母婴抗体水平,减少婴儿初免前暴露;同时不影响基础免疫成功率和GMRT水平,对降低婴儿麻疹发病,实现消除麻疹具有重要意义。

Studies on the effect of measles vaccination for women of childbearing ages on the incidence of infant measles

Objective To study the effect of measles vaccination for women of childbearing ages on the incidence of infant measles.Methods A retrospective study was conducted in which data of infants with measles were collected and analyzed from 2006to 2012in Zaozhuang.Antibody against measles was detected among women of childbearing ages as well as infants by ELISA.Spss11.5was used for data analysis.Results The annual average incidence of infant measles dropped to 34.08/100 000after women immunized with MV.Half infant measles cases occurred because their mothers were vaccinated two years or even longer before their pregnancy,and 42.11%（16/38）of infant cases were younger than 8 months.The antibody positive rate of women of childbearing ages and GMRT were 95.73% and 1 300.52,respectively,and dropped rapidly to 82.05% and 521.35 24months before the pregnancy which were close to pre-immunization level.The antibody positive rate and GMRT among infants aged 0-8months whose mothers were vaccinated 3-6and 8-12months before pregnancy were significantly higher compared with that in control group（χ^2=27.92,24.41;t= 10.23,9.78;P0.01）.The differences of antibody positive rate（76.19-90.00%）and GMRT（672.24 -712.56）in infants of 8-month age were not significant（χ^2=1.54,F=0.47,P0.05）.Conclusions MV vaccination for women of childbearing ages 3-12months before pregnancy can increase the antibody level of both mothers and infants,reduce the risk of measles virus exposure of infants.Meanwhile,there is no effect on the base immune success rate and GMRT.