昆明市ACYW135流脑疫苗免疫学效果分析

Immunological effect analysis of ACYW135 vaccine in epidemic cerebrospinal meningitis in Kunming city

目的:了解昆明市健康人群脑膜炎奈瑟氏菌(Nm)Y、W135群流脑抗体水平以及ACYW135群流脑疫苗的免疫学效果,为ACYW135流脑疫苗在昆明市的科学使用提供依据。方法:随机抽样昆明市城镇、农村地区三年内未接种ACYW135流脑疫苗的人群,共654人(男性313人,女性341人)做为研究对象。于接种ACYW135流脑疫苗前三天、接种后一个月、一年分三次采集血清,采用酶联免疫吸附试验(ELISA)、流脑杀菌抗体测定(TTC)法检测血清中流脑Y群、W135群流脑抗体水平。结果:调查654人,接种疫苗前,Y群流脑抗体阳性率18.04%,GMT为6.14,W135群流脑抗体阳性率23.09%,GMT为3.62;Y、W135群流脑抗体阴性者接种疫苗一个月后,Y群流脑抗体阳转率88.25%,总体GMT为72.74;W135群流脑抗体阳转率87.05%,总体GMT为45.95。接种一年后进行免疫持久性观察,Y群抗体阳性者转阴率为3.17%、GMT为27.94;W135群抗体阳性者转阴率为5.30%,GMT17.72。与免疫后一个月抗体阳性率比较,无统计学差异。结论:昆明市健康人群流脑Y群和W135群抗体水平均较低,ACYW135流脑疫苗具有良好的流行病学保护效果,免疫持久性好,保护期在一年以上,在人群中有计划的接种含有W135群和Y群的ACYW135流脑疫苗是必要的。

Objective：To understand the antibody level of Neisseria meningitides group （Nm ）Y, W135 in healthy population and immunological effect of group ACYWx35 in Kunming city, and provide evidence for scientific usage of ACYW135 epidemic cerebrospinal meningitis vaccine. Methods： 654 （313 males, 341 females） people were sampled randomly from population without inoculation of ACYW135 epidemic cerebrospinal meningitis vaccine in last 3 years in Kunming city. Blood were collected 3 days before, 1 month after and 1 year after inoculation respectively. ELISA and T＇FC were adopted to detect antibody level of group Y and W135 of Neisseria meningitides. Results： 654 cases were involved. Before inoculation, antibody positive rate of group ~ was 18.04% , antibody geometric mean titer （GMT） was 1：6.14 ; antibody positive rate of group W135 was 23.09% with GMT 1 ： 3.62. The proportion of cases with negative Y group antibody turned to positive 1 month after inoculation was 88.25% with GMT 1：72.74; for W135 group, the data were 87.05% and 1：45.95 respectively. The vaccine presented good immune effect. 1 year after inoculation, the proportion of positive case of Y group turned to negative was 3.17% , with GMT 27.94; for group W135, the negative conversion rate was 5.30% , and GMT was 17.72. There was no statistic difference between antibody positive rates of cases 1 month and 1 year after inoculation. Conclusion： Anfbody level of Y group and W135 group Neisseria meningitides is low in healthy population in Kunming city. ACYW135 epidemic cerebrospinal meningitis vaccine can provide good epidemical protection with immune persistence for more than one year.Therefore, it is necessary to inoculate ACYW135 vaccine among healthy population.