社区儿童接种b型流行性感冒嗜血杆菌结合疫苗的前瞻性队列研究

A Prospective Cohort Study on Community Children Vaccinated with Haemophilus Influenzae Type b

目的评价社区儿童接种b型流行性感冒嗜血杆菌[Haemophilus Influenzae(Hi)Type b,Hib]结合疫苗的免疫效果。方法采用前瞻性队列研究方法分为疫苗接种组与非疫苗接种(对照)组,用细菌培养法、巢式聚合酶链反应检测两组儿童Hi携带状况,分析Hi携带率及下呼吸道疾病罹患率。结果两组儿童Hib携带率均较低;对照组未定型Hi阳性率显著高于接种组,以2～3岁尤为明显;各年龄组中对照组儿童支气管炎罹患率均显著高于接种组,Hib结合疫苗对儿童支气管炎发病的保护效果>90%;对照组中Hi培养阳性者气管炎发病显著高于Hi培养阴性者。结论儿童支气管炎的发病与Hi携带率高有关,接种Hib疫苗后导致Hi携带率下降以及支气管炎发病减少。

Objective To evaluate the epidemiological effect of Haemophilus influenzae type b conjugate vaccine（Hib）.Methods Prospective Cohort Study was conducted to detect carrier rate of Hi in unvaccinated and vaccinated children by bacteria culture and Nest-PCR.Carrier rate of Hi and the incidence of lower respiratory tract infection in two groups children were analysed.Results The carrier rate of Hib in two groups children was very lower.The positive rate of NTHi in unvaccinated children was higher than vaccinated children significantly,which was mainly happened in the Children of 2～ 3 years old.The incidence of lower respiratory tract infection in unvaccinated chiidren was higher than vaccinated children obviously.The protective effect of Hib vaccine against bronchitis was over 90%.The incidence of bronchitis of Hi culture positive was higher than that of Hi culture negative significantly. Conclution Children’s bronchitis is related to the Hi carrier rate.To inoculate Hib vaccine can reduce the carrier rate of Hi and the incidence of bronchitls.