505名医务人员接种甲型H1N1流行性感冒疫苗3个月内的免疫效果分析

Immune effectiveness of A/H1N1 influenza vaccine immunization in 505 health care workers within three months after vaccination

目的 了解内蒙古大兴安岭地区医务人员接种甲型H1N1流行性感冒（流感）疫苗的免疫效果.方法 采用单纯随机抽样方法,通过ELISA法对505名接种和129名未接种H1N1流感疫苗的健康医务人员半定量测定血清H1N1流感IgG.按年龄、性别、职业和从接种到不同采样时间检测结果进行分组分析.率的比较行x2检验.结果 505名医务人员接种甲型H1N1流感疫苗后,401人特异性抗体阳性,占79.4%;弱阳性50人,占9.9%.129名未接种组中特异性抗体阳性59人,占45.7%;弱阳性15人,占11.6%.两组各年龄分层比较差异无统计学意义（P＞0.05）.接种组男性抗体阳转率为95.7%,女性为87.4%（x2=6.40,P＜0.05）;未接种组男性抗体阳转率为73.3%,女性为52.5%（x2=4.07,P＜0.05）.接种组护士和医生的阳转率分别为86.0%和94.5%（x2=9.16,P＜0.01）,未接种组分别为43.8%和75.0%（x2=12.61,P＜0.01）.从接种到不同采样时间特异性抗体检测结果比较,接种第80～89天阳转率为81.5%,与接种第30～39、50～59、60～69天的阳转率分别为100.0%、94.7%和93.6%比较,差异有统计学意义（x2=3.96,P＜0.05;x2=7.15,P＜0.01;x2=9.98,P＜0.01）.结论 内蒙古大兴安岭地区医务人员甲型H1N1流感疫苗接种有良好免疫效果.免疫后第80～89天免疫水平较前有显著下降.

Abstract：Objective To investigate the immunization effect of influenza A/H1N1 vaccine in health care workers （HCW） in Inner Mongolia Greater Khingan Mountains area. Methods Five hundred and five HCW who received A/H1N1 influenza vaccination （immunized group） and 129 staffs who didn＇t receive the vaccination （unimmunized group） were randomly sampled for semiquantitative testing of serum H1N1 antibody （IgG） levels by enzyme-linked immunosorbent assay （ELISA）.Results were analyzed and stratified by age, sex, occupation and the time interval between the time of vaccination and serum sample collection. The antibody positive rates of the two groups were compared by x2test. Results There were 401 （79. 4%） HCW whose H1N1 antibody were positive and 50 （9.9%） whose antibody were weak positive among 505 immunized HCW. While among 129 unimmunized HCW, there were 59 （45.7%） whose antibody were positive and 15 （11.6%） whose antibody were weak positive. The seroconversion rates of specific antibody were not significantly different among the different age groups after receiving A/H1N1 influenza vaccine （P〉 0.05）.However, there were statistical differences of the seroconversion rates among different sex groups （men 95.7% vs women 87.4% in immunized group, x2=6.40, P〈0.05; and men 73.3% vs women 52.5% in unimmunized group, x2 =4.07, P〈0.05） and different occupation groups （doctor 86.0% vs nurse 94.5% in immunized group, x2 = 9. 16, P〈0.01; and doctor 43. 8% vs nurse 75.0% in unimmunized group, x2=12.61, P〈0.01 ）. The seroconversion rate was 81.5% after 80 to 89 days of vaccination, which was significantly lower than those after 30 to 39, 50 to 59 days and 60 to 69 days of vaccination, which was 100.0%, 94.7% and 93.6%, respectively （x2 =3.96, P 〈0.05; x2=7.15, P 〈0. 01; x2 = 9. 98, P〈0. 01）. Conclusions A/H1N1 influenza vaccination can induce effective immune response in HCW in Greater Khingan Mountains area of Inner Mongolia. However,the level of specific antibody significantly reduces after 80 to 89 days of vaccination.