狂犬病病毒高危暴露者使用2-1-1程序预防效果分析

Analysis of preventive effects of rabies vaccination with Zagrab regimen on persons with high-risk exposure to rabies virus

目的探索人用狂犬病疫苗(辽宁成大生物股份有限公司)2-1-1程序能否对狂犬病病毒高危暴露者达到预防效果。方法把29例狂犬病病毒高危暴露者按照原卫生部处置规范分成Ⅱ级暴露组(n=10)、Ⅲ级暴露组(n=19),其中Ⅱ级暴露组按2-1-1程序接种狂犬病疫苗后检测抗狂犬病中和抗体;Ⅲ级暴露组首次接种狂犬病疫苗的同时还接种狂犬病免疫球蛋白;不同组采用狂犬病中和抗体阳转率及平均滴度进行效果分析。结果狂犬病高危暴露者全程使用2-1-1程序后有效得到保护;针对29例狂犬病病毒高危暴露者处置后调查,两组中和抗体阳转率为100%;Ⅲ级暴露组(注射狂犬病免疫球蛋白)与Ⅱ级暴露组(不注射狂犬病免疫球蛋白)中和抗体滴度分别为(7.31±2.03)U/mL和(8.27±2.39)U/mL,两组比较,差异无统计学意义(t=1.16,P>0.05);不同年龄段均产生较相近的阳性滴度,差异无统计学意义(F=1.15,P>0.05);不同性别暴露者产生抗体滴度差异无统计学意义(t=1.19,P>0.05)。结论结合正规的伤口处置,人用狂犬病疫苗2-1-1程序对狂犬病病毒高危暴露者能达到较好的预防效果。

Objective To explore the effects of rabies vaccination produced by Chengda Biotechnology with Zagrab regimen on persons with high-risk exposure to rabies virus. Methods 29 persons with high-risk exposure to rabies virus were divided into groups of grade Ⅱ（n=10） and grade Ⅲ（n=19）, according to the disposal specification for exposure to rabies made by former Ministry of Health. The persons of grade Ⅱ group were injected with rabies vaccination under Zagrab regimen only, and the persons of grade Ⅲ group were injected with both rabies vaccination and immunoglobulin.Serum specimens of those persons were detected for the neutralizing antibody against rabies, and analysis on the effect was conducted between two groups using the seroconversion rate and geometric mean titers of rabies neutralizing antibody. Results The persons with high-risk exposure to rabies were effectively protected by injecting rabies vaccination with Zagrab regimen. It showed that the conversion rate of neutralizing antibody of 29 persons in two groups was 100%.The geometric mean titre of neutralizing antibodies in grade Ⅲ group（injection of rabies immune globulin） and grade Ⅱgroup（none of the injection of rabies immune globulin） were（7.31±2.03） U/mL and（8.27±2.39） U/mL respectively, there was no statistical significance between two groups（t=1.16, P〉 0.05）. No statistical significances in different age groups（F=1.15, P〉 0.05） and in different gender groups（t=1.19, P 〉0.05） were observed. Conclusion Combined with correct wound treatment, rabies vaccination with the Zagrab regimen can play a preventive role for persons exposed to rabies virus.