广州市2009-2011年健康人群流脑免疫水平及带菌状况分析

Level of immunity against epidemic cerebrospinal meningitis and the carrier status among healthy population in 2009-2011 in Guangzhou

目的了解广州市人群流脑带菌状况及抗体水平,为制定有效的防控措施提供依据。方法 2009-2011年每年均采用分层随机抽样方法,采集8个年龄组健康人群的咽拭子和血液标本进行脑膜炎奈瑟氏菌分离鉴定及C群抗体杀菌力试验。结果广州市2009-2011年健康人群平均带菌率为0.8%,菌群以B群为主,同时检出W135群。不同年龄组人群、不同性别人群带菌率差异均无统计学意义。C群抗体平均阳性率为39.1%,平均保护率为31.9%。各年龄组人群流脑抗体阳性率不同,3～岁组最高(59%),其次为5～岁组(54.9%),1～岁组最低(19.0%),各组阳性率差异有统计学意义(χ2=63.69,P<0.05)。不同性别抗体阳性率差异无统计学意义(χ2=1.26,P>0.05),已接种疫苗者与未接种疫苗者抗体水平差异有统计学意义(χ2=57.84,P<0.001)。结论广州市健康人群流脑带菌率低,要警惕B群引起的散发疫情。应提高人群尤其是3岁以下婴幼儿C群流脑抗体水平。

Objective To understand the level of immunity against epidemic cerebrospinal meningitis and the carrier status of epidemic cerebrospinal meningitides in the healthy population,and to provide scientific basis for prevention and control.Methods Blood specimens and throat swab were collected from the normal subjects from 8 different aged groups in Guangzhou.Microbiological methods were used for the identification of Neisseria meningitides,and the level of antibody against Neisseria meningitides group C was also measured.Results The carrier state of Neisseria meningitides in the healthy population was 0.8%,and the isolates were mainly group B and group W135.The carrier status was similar between the male and female subjects,and also in the subjects of different age groups.The positive rate and protective rate of serum antibody against group C was 39.1% and 31.9%,respectively.The level of antibody against group C was higher in the meningococcal polysacharide vaccinated subjects （χ2 =57.84,P＆lt;0.001）.Conclusion The carrier ststus of Neisseria meningitides in the healthy population is relatively low.It is necessary to increase the level of protective antibody against group C Neisseria meningitides in children under 3 years old.