百白破联合疫苗常规免疫后白喉抗体水平监测分析

目的 为了解云南省玉溪市1～7岁儿童在接种百白破混合制剂(DPT)后白喉的免疫状况,以便为制定白喉的免疫策略措施提供科学依据.方法 对2003-2005年具有DPT免疫史的1937名1～7岁儿童的血清标本采用间接血凝法(IHA)检测抗毒素.结果 白喉免疫抗体总阳性率94.84%;保护率90.76%;几何平均滴度(GMT)1:52.23;抗毒素平均含量(ATC)0.15 IU/ml.男女之间白喉免疫抗体阳性率差异无统计学意义(2=2,P＞0.05),GMT、保护率差异有统计学意义(u=3.3、2=7.87、,P均＜0.05).不同地区阳性率、保护率、GMT差异有统计学意义(2=7.75、22=14.1、F=43.2,P均＜0.05).不同年龄组阳性率、保护率、GMT差异有统计学意义(12=21.59、22=27.1、F=7.32,P均＜0.05).不同年度阳性率、保护率、GMT差异有统计学意义(12=9、22=37.1、F=22.21,P均＜0.05).结论 玉溪市DPT接种质量保证,在1～7岁儿童中免疫抗体居于高水平状态,并形成牢固的免疫屏障,预测玉溪市近年不会发生白喉流行.

Surveillance analysis of diphtheria antibody levels after routine DPT vaccination

Objective The present study was conducted to find out the status of immunity against diphtheria after DPT(diphtheria-pertussis-tetanus vaccine)vaccination in children aged from 1 to 7 in Yuxi City of Yunnan Province to provide a scientific basis for the development of strategies for anti-diphtheria immunization.Methods Indirect hemagglutination assay(IHA)was used to detect the antitoxins in the serum samples collected from 1937 children aged 1-7 who had had DPT vaccination from 2003 to 2005.Results The overall positive rate of diphtheria immune antibodies was 94.84% with the protection rate being 90.76%,the geometric mean titer(GMT)1∶52.23,and the mean antitoxin content(ATC)0.15IU/ml.There was no significant difference found in the positive rate of diphtheria immune antibodies between the boys and the girls(X2=2,P0.05),while their difference in the mean titer and protection rate were statistically significant(u=3.3,X2=7.87,both P0.05).There were statistically significant difference in the positive rate,protection rate and GMT between different areas(X2=7.75,X22=14.1,F=43.2,both P0.05),age groups(X12=21.59,X22=27.1,F=7.32,both P0.05)and years(X12=9,X22=37.1,F=22.21,both P0.05).Conclusion The quality of DPT vaccination is well controlled in Yuxi city,and a high immune antibody status in children aged 1-7 and a solid immune barrier have been maintained.It's predicted that a diphtheria epidemic is not likely to occur in the city in coming years.