百日咳、白喉、破伤风的血清流行病学监测及方法学研究

Seroepidemiological Surveillance and Methodological Study of Pertussis, Diphtheria and Tetanus

１９９３～１９９４年应用日本国立卫生研究所研制的明胶颗粒凝集试验（ＰＡ）对我国ＤＰＴ的诊断方法进行了研究，同时对人群ＤＰＴ的抗体水平进行了监测。此次调查１９９３年采血９００人份，１９９４年采血３００人份，结果表明ＰＡ法使用方便，结果稳定，易于观察，可弥补我国被动血凝试验（ＰＨＡ）存在的缺陷，检测白喉和破伤风与国内ＰＨＡ法有较好的相关性，但ＰＨＡ法似更敏感，检测百日咳ＰＡ法与国内微量凝集试验（ＭＡ）相关性较差，ＭＡ法较ＰＡ法敏感得多。人群ＤＰＴ抗体水平检测结果表明，人群抗体水平不是很高，分别为百日咳阳性率为９５．０％，≥１：３２０的为４．７％，ＧＭＴ为１：１２１；白喉阳性率为６２．９％，ＧＭＴ为０．０２８０ＩＵ／ｍｌ；１９９３年破伤风阳性率为７０．５％，ＧＭＴ为０．１４１０ＩＵ／ｍｌ；１９９４年破伤风阳性率为７５．７％，ＧＭＴ为０．３２８１ＩＵ／ｍｌ，提示应重视加强基础免疫和强化免疫。调查结果还显示，抗体水平城市高于农村，并随年龄增高而下降，大年龄组抗体水平较低，造成目前大年龄组发病较高。

n this paper,we studied the diagnostic method of DPT using PA method developed by Japanese National Institute of Health(NIH)in 1993 1994, meanwhile we surveyed the antibody level of DPT. We collected 900 sera samples and 300 sera samples from Hebei province in 1993 and 1994.The result showed that PA method was simple,reliable and easy to observe,which can make up the shortages existed in PHA method. The antitoxin titers obtained by the PA method correlat-ed well with the PHA method,while the latter was more sensitive. The antibody level of pertussis obtained through PA method did not correlate well with MA method.The result also showed that the antibody level of DPT was not high,with a 95.0% positive rate of pertussis. The rate of titers higher than 1 :320 was 4.7% with GMT 1: 121;the positive rate of diphtheria was 62.9% with GMT 0.0280 IU/ml,in 1993 the positive rate of tetanus was 70.5% with GMT 0.1410 IU/ml,in 1994 the positive rate was 75.7%with GMT 0.3281IU/ml. The titers in urban areas were higher than in rural areas and a decrease was observed with the increase of age. The titers in males was similar to in females. According to this result,a routine immunization followed by booster program should be emphasized.