上海市长宁区156例麻疹疑似病例血清IgM抗体检测结果分析

Analysis of the results of serum IgM antibody detection among 156 borderline cases of measles in Changning District of Shanghai

目的分析近年来上海市长宁区麻疹的流行情况,评价麻疹疑似病例的血清学诊断。方法对2002年1月至2006年3月长宁区麻疹疑似病例的流行病学调查和血清学检测结果进行分析。结果156例麻疹疑似病例麻疹IgM抗体阳性率为85.90%。不同年龄组间IgM抗体阳性率差异有显著的统计学意义,<8月龄组和≥20岁的成年人组IgM抗体阳性率较高,而8月龄至4岁及5～19岁组阳性率较低。不同免疫史组间IgM抗体阳性率差异也有显著的统计学意义,有免疫史组的阳性率低于无免疫史及免疫史不详组。不同采样时间IgM抗体阳性率不同,出疹当天采集的血清阳性率最低。结论继续做好麻疹疫苗的常规免疫和强化免疫工作,控制成年人麻疹病例的发生,提高麻疹实验室监测的敏感性和准确性可促进麻疹的控制与消除。

Objective This study was conducted to analyze the epidemic characteristics of measles and evaluate the serological diagnosis of borderline cases in Changning District of Shanghai. Methods Results of epidemiological survey and serological tests among borderline cases of measles in Changning District from Jan. 2002 to Mar. 2006 were taken into analysis. Results The positive rate of IgM antibody among 156 borderline cases of measles was 85.90%, significantly different among age groups, while the positive rate was higher in yonunger-than-8-month group and over 20-year-old adult group and lower in 8-month-old to 4-year-old group and 5-year-old to 19-year-old group. The positive rate was also significantly different among groups with different immunity history, lower in the immunized group than the non-immunized group and the one with unknown immunity history. The positive rate was different among groups with different serum-collecting time, lowest in the group where serum was collected on the day eruption appeared. Conclusion Conventional immunity of measles vaccine and enhanced immunity should be further conducted to control the incidence of measles among adults. Improving the sensitivity and specificity of immunological surveillance of measles would favor the control and prevention of measles.