百日咳高发地区血清流行病学病例对照研究

Case-control Study on Serum in Epidemiology on Pertussis in Epidemic Area

目的研究百日咳高发地区报告病例的自然感染和疫苗接种情况,为发现相关危险因素和制定监测病例定义提供依据。方法用酶联免疫吸附试验对报告的百日咳病例和选择的对照进行百日咳抗体和白喉抗体检测,评价疫苗接种和自然感染对百日咳病例的影响。结果病例组百日咳IgG抗体阳性率(82.2%)显著高于对照组(40.0%),而白喉IgG抗体阳性率(11.1%)显著低于对照组(36.3%)。临床诊断病例的百日咳抗体阳性率(87.8%)显著高于疑似病例(25.0%)。对照组中百日咳抗体阳性率随着年龄的增长而增高(χ2=14.22,P=0.000 8)。85.3%的白喉抗体阳性者调查显示有百白破联合疫苗(DPT)接种史,但调查时提供有DPT接种史者中,白喉抗体阳性率为37.2%。结论DPT接种是影响百日咳发病的重要因素,监测病例定义能较好地发现真实的百日咳病例。

Objective To study the situation of natural infection and vaccination on the pertussis cases in epidemic areas,in order to find the risk factors and conduct a surveillance case definition. Methods To test pertussis IgG and diphtheria IgG on 45 cases and 80 controls by Elisa. Results Pertussis IgG positive rate is 82. 2% in cases,vs. 40.0% in controls （OR=6.94,95% CI. 2.86-16.82）.Diphtheria IgG positive rate is 11.1% in cases,vs. 36.3% in controls （OR= 0.22,95% CI：0.08-0. 62）. 87.8% of clinical diagnosis cases have pertussis IgG,vs. 25.0% in suspectable cases （χ^2 =9.83 ,P=0. 014）. The pertussis antibody positive rate,is rising with age in control group（χ^2 =14. 22,P=0. 0008）. 85.3% of diphtheria IgG positive cases has got vaccinated DPT by immunization records or parent memory. 37.2 % of recording vaccinated person has diph- theria IgG. Conclusion DPT vaccination is the important factor in affecting the epidemic of pertussis. The case definition has a good coincidence with real pertussis cases;it is useful in case surveillance definition.