麻疹 流行性腮腺炎 风疹联合疫苗2剂免疫的效果观察

Observation on Immunization Effectivity of 2 Doses of Combined Measles,Mumps,Rubella Vaccine

为观察麻疹、流行性腮腺炎 (腮腺炎 )、风疹联合疫苗 (MMR) 2剂免疫的效果 ,选择 8月龄已接种 1剂麻疹疫苗、且在 12～ 18月龄已接种 1剂MMR ,无风疹疫苗及腮腺炎疫苗免疫史的健康儿童 110人 ,在 4周岁时进行第 2剂MMR免疫 ,并在免疫前和免疫后 1个月分别采集手指末梢血 0 3ml,检测麻疹IgG抗体、腮腺炎血凝抑制 (HI)抗体、风疹HI抗体。结果显示 :观察对象在 4周岁时进行第 2剂MMR免疫前 ,麻疹IgG抗体阳性率 10 0 0 0 % ,风疹HI抗体阳性率 10 0 0 0 % ,而腮腺炎HI抗体阳性率 5 8 18%。而第 2剂MMR免疫后 ,麻疹IgG抗体阳性率仍为 10 0 0 0 % ,几何平均滴度 (GMT)为 1∶2 6 78,较免疫前≥ 4倍增长率为 14 6 8% ;风疹HI抗体阳性率仍为 10 0 0 0 % ,GMT为 1∶6 11 90 ,较免疫前≥ 4倍增长率为 5 0 4 8% ;腮腺炎HI抗体阳性率为 98 0 0 % ,GMT为 1∶32 4 9,较免疫前≥ 4倍增长率为 6 9 0 9%。表明MMR 2剂的免疫效果较好 ,为了消除麻疹、风疹、先天性风疹综合征及控制腮腺炎 ,上海市应借鉴美国的经验 ,在进一步开展接种MMR流行病学效果调查的基础上 ,适时调整免疫策略 ,采取 2剂MMR接种方案。

In order to observe the immunization effectivity of 2 doses of MMR,we chose 110 healthy children without rubella vaccine and mumps vaccine vaccination history who had received one dose measles vaccine in 8 months old and one dose MMR in 12～18 months old When they were 4 years old,give them the second dose MMR,and collect 0 3ml finger blood one month before and after vaccination to test the antibody level The results showed before the second dose MMR,the serum IgG positive rate of measles,HI antibody of rubella,HI antibody of mumps were 100 00%,100.00% and 58 18% respectively After the second dose MMR vaccination,the serum IgG positive rate,the GMT,the rate of antibody increasing above 4 times more than the antibody before vaccination of measles were 100 00%,1∶2678 and 14 68% respectively;the HI antibody positive rate,the GMT,and the rate of antibody increasing above 4 times more than the antibody before vaccination of rubella were 100 00%,1∶611 90 and 50 48% respectively;the HI antibody positive rate, the GMT,and the rate of antibody increasing above 4 time more than the antibody before vaccination of mumps were 98%,1∶32 49 and 69 09% respectively It showed that the immunization effectivity of MMR2 was good In order to eliminate measles,rubella,congenital rubella syndrome and control mumps,Shanghai should use the experience of the United States of America for reference,on the basis of the epidemiological effectivity of carrying out MMR vaccination,adapt the strategies of immunization timely,and begin to carry out 2 dose MMR vaccination schedule