2004年全国计划免疫审评不同免疫覆盖率县的儿童脊髓灰质炎中和抗体水平调查

Review on Neutralized Antibody of Polio in Children in Counties with Different 4-Vaccine Coverage Rates in National Immunization Programme in 2004

目的了解2004年全国计划免疫审评不同免疫覆盖率县的儿童脊髓灰质炎（脊灰）中和抗体水平。方法根据2004年全国计划免疫审评县四种疫苗[卡介苗、口服脊灰减毒活疫苗（OPV）、百白破联合疫苗、麻疹减毒活疫苗]免疫覆盖率不同分为3层，每层随机抽取2个县，每个县随机调查10个村，每个村随机调查1992～2003年出生儿童42名；检测方法用微量组织培养法。结果①被调查儿童建卡率和建证率分别为66．5％和75．3％。②脊灰Ⅰ、Ⅱ、Ⅲ型中和抗体阳性率分别为96．9％、98．6％、93．7％；几何平均滴度（GMT）分别为1：113．2、1：83．7、1：40．5。③各型抗体GMT均随年龄增长呈明显下降的趋势。④不同免疫覆盖率儿童与脊灰中和抗体阳性率无相关性。结论本次调查地区儿童脊灰中和抗体阳性率、GMT总体保持在较高水平，但是个别地区的个别年龄组儿童较低。儿童OPV的接种率不能客观反映儿童脊灰的抗体水平。

Objective To investigate the immunity levels of polio neutralized antibody of children in areas at different 4-vaccine coverage rate levels stratified by results of national immunization program （NIP） review in 2004. Method It was divided into 3 levels according to investigated 4-vaccine coverage rates of NIP review in 2004. We selected 2 counties in each level, 10 villages in each selected county,42 children born from 1992-2003 were engaged in the study. Micro-tissue culture method was used. Results （1） Investigated card rate and certificate rate are respectively 66.5% and 75.3%. （2） Rates of neutralized antibodies positive to Ⅰ ,Ⅱ ,and Ⅲ are 96.9% ,98.6% and 93.7%. （3）GMTs of neutralized antibodies positive to Ⅰ ,Ⅱ ,and Ⅲ are respectively 1 ： 113.2,1 ： 83.7 and 1：40.5. respectively （4）GMTs present a trend of decreasing as age＇s increasing. （5）The relation between rates of neutralized antibodies and 4-vaccine coverage rates was not found. Conclusions Rates of neutralized antibodies of polio are generally high in investigated children but still low in very few age-group of specific areas. Coverage rate of polio vaccine can not reflect the truth of children＇s immunity from polio.