不同因素下婴儿麻疹抗体水平检测及研究

Study on measles antibody levels of infants with different characters

目的分析不同因素下婴儿麻疹抗体水平,为制定麻疹的防控策略提供依据。方法选取2015年1月至2018年1月在湖北省鄂州市出生且小于8月龄的婴儿作为调查对象,共216例。收集调查对象的一般人口学信息、出生信息及其母亲的年龄等,并采集其0、3、5和7月龄血清,采用酶联免疫吸附试验检测血清麻疹IgG抗体的几何平均浓度;采用x2或x2趋势检验比较不同特征婴儿间血清麻疹IgG抗体阳性率及中高抗体比例的差异。结果婴儿胎龄的中位数(P25,P75)为39(38,40)周,麻疹IgG抗体阳性率为74.1%。其中,母亲年龄为19~36岁和37~45岁婴儿的阳性率分别为71.9%和95.0%(P=0.025)。自然分娩婴儿的阳性率为83.8%,高于剖宫产(52.9%,P<0.01),中高抗体比例为33.8%,也高于剖宫产新生儿(14.7%,P=0.004);胎龄为32~36周和37~41周婴儿麻疹抗体阳性率分别为52.6%和78.7%(P=0.001);出生体重为1.9~2.9和3~4.5kg婴儿的阳性率分别为59.3%和79.6%(P=0.002)。出生时婴儿血清麻疹IgG抗体几何平均浓度为662.0mIU/mL,而当3、5和7月龄时分别降至189.5、97.0、和53.1mIU/mL。婴儿麻疹抗体阳性率随月龄增加呈下降趋势(P<0.01),其中0月龄婴儿最高,为74.1%,7月龄最低,为5.1%。结论母亲更高年龄、自然分娩、足月、高出生体重、更低月龄因素下,婴儿麻疹抗体水平相对较高。

ObjectiveTo explore the antibody level of measles among infants of various characters, so as to provide evidences for scientific prevention of measles.MethodsFrom January, 2015 to January, 2018, a total of 216 infants younger than 8 months of age in Ezhou city, Hubei province were included in the study. Unified questionnaires were used to investigate general demographic information, birth information, maternal age, and blood samples of infants at different time (0, 3, 5 and 7 month of age) were collected. All serum samples were tested by enzyme linked immunosorbent assay for quantitative measurement of measles IgG antibody. Differences between the positive rates as well as percentages of medium-and-high antibody titer of infants with different characteristics were analyzed by Chi-square and trend Chi-square tests.ResultsThe median gestational age (P25, P75) was 39 (38-40) weeks. The positive rate of measles antibody was 74.1%. For the infants whose mothers were 19-36 years old and 37-45 years old, the positive rates of measles antibody were 71.9% and 95.0%, respectively (P=0.025). The positive rate of measles antibody among newborns delivered by natural childbirth (83.8%) was higher than that of newborns by cesarean section (52.9%, P<0.01). The percentage of median-and-high antibody titer of newborns by natural delivery was 33.8%, which was higher than that of newborns by cesarean section (14.7%, P=0.004). The positive rates of measles antibody among newborns with gestational age of 32-36 weeks and 37-41 weeks were 52.6% and 78.7%, respectively (P=0.001). The positive rates of measles antibody among newborns with birth weight of 1.9-2.9 kg and 3.0-4.5 kg were 59.3% and 79.6%, respectively (P=0.002). The geometric value of measles antibody level at birth was 662.0 mIU/mL, and dropped to 20.3 mIU/mL, 97.0 mIU/mL and 53.1 mIU/mL at the age of 3, 5 and 7 months, respectively. The level of measles antibody decreased along with age (P<0.01). The positive rate decreased from the highest level of 74.1% at 0 month of age to the lowest of 5.1% at 7 month.ConclusionsOlder maternal age, natural childbirth, heavier birth weight, younger month age related to higher levels of measles antibody in infants.