土拉弗氏菌病患者血清抗体20年变化趋势分析

Analysis on alternation trend of antibodies in tularemia patients from 1985 to 2005

目的了解土拉弗氏菌病患者免疫力维持时间、影响因素及一般人群中隐性感染情况。方法分别于发病后3周,6个月,2,3,6,7,8,9,20年采集血清,对山东省胶南县原外贸冷藏厂的31名土拉弗氏菌病患者及同地区一般人群进行纵向队列研究,检测血清中土拉弗氏菌特异性抗体,当效价>1∶40时为阳性;并于2005年对其发病状况和行为习惯等进行回顾性调查。结果病例组抗体几何平均滴度(GMT)从1986年的11890.00逐年下降到2005年的46.94,抗体效价衰减率为59.1%。早期抗体水平与后期抗体水平相关分析系数r=0.659(P<0.05),二者呈正相关。问卷调查表明,发病状况和行为习惯等与后期抗体水平的差异无统计学意义(P>0.05)。对照组历年来均为阴性。结论部分患者血清的土拉弗氏菌特异性抗体可长期存在,并呈逐渐下降趋势,而且后期抗体水平很大程度上受早期抗体效价高低的影响,与其他因素无关。一般人群无隐性感染。

ObJective To study the maintainable time of humoral immunity against Francisella tularensls after irdection, influence factors and the recessive infection situation in healthy people. Methods Thirty - one subjects with acute tularemia and the same area healthy people were studied for antibodies to Francisella tularensis by using Immuno - Chromatographic Assay（ICA） in third week（Jan., 1986）, sixth month（July, 1986）, second year（1987）, third years（1988）, sixth year（1991）, seventh year（1992）, eighth year（1993）, ninth year（1994）, twentieth year（2005）. Special antibody were detected in the cohort study. Titers of 〉 1 ： 40 were defined as positive . And the subjects were retrospectively studied in 2005. Resuits The GMT of subjects decreased from 11890.00 （ in 1986） to 46.94（ in 2005）. The rate of decay was 59.1%. A correlation was known between the titer of earlier period and that of the late - phase（ r = 0. 659, P 〈 0.05）. There were no statistically significant difference between the content of questionnaire and the late - phase titer. The control group was negative result during 20 years. Conclusion Special antibody in partial patients can last for a long time with a gradual reducing trend . The titer of the earlier period influence significantly that of the late - phase without other factors. And there is no recessive infection in the healthy people.