狂犬病疫苗的不同接种方案对不同人群的免疫效果观察

Immune effect of different rabies vaccination regimen in different people groups

目的观察狂犬病疫苗不同接种方案对不同人群的免疫效果。方法收集2013年5月到9月间在本院急诊科动物咬伤门诊接种人狂犬病疫苗的志愿者,分别接种传统的5针法(n=36)和2-1-1接种方案(n=73),根据3年以前有无狂犬病疫苗接种史分成4组:A组(2-1-1初种组,n=49)、B组(5针初种组,n=23)、C组(2-1-1复种组,n=24)和D组(5针复种组,n=13)。分别检测接种首日、接种第7、21和45天各组接种者血清狂犬病抗体阳性率。结果狂犬病疫苗5针法接种与2-1-1方案在首日、第7、21和45天时抗体阳性率比较差异均无统计学意义(P>0.05)。第45天每种方案的初种组与复种组阳性率比较差异无统计学意义(P>0.05),但首日及第7和21天的阳性率比较差异均有统计学意义(P<0.05)。结论狂犬病疫苗5针法与2-1-1接种方案免疫效果相当,复种者早期(第7天)即可达到血清抗狂犬病抗体阳性。

Objective To observe immune effect of different rabies vaccination regimen in different people groups.Methods The volunteers of post-exposure prophylaxis were collected in outpatient department about animal bite from Mayto September 2013, including 36 cases of five-dose regimen and 73 cases of 2-1-1 regimen. According to the past historyof rabies vaccination before three years, the volunteers were divided into four groups to statistically analyze the immuneeffect： group A （first-immunization of “2-1-1” regimen without past history of rabies vaccination, n=49）; group B （firstimmunizationof five-dose regimen without past history of rabies vaccination, n=23）; group C（re-immunization of “2-1-1”regimen with past history of rabies vaccination, n=24）; group D （re-immunization of five-dose regimen with past history ofrabies vaccination, n=13）. The positive rate of serum rabies neutralizing antibodies in each group was tested respectively on1st、7th、21st、45th day. Results There was no statistical difference of the positive rates between five dose regimen and “2-1-1”regimen on 1st、7th、21st、45th day （P 〉 0.05） respectively. There was statistical difference between first-immunization andre-immunization in both five-dose regimen and “2-1-1”regimen on 1st、7th、21st day （P 0.05）. Conclusion There is no significantdifference between five-dose regimen and “2-1-1”regimen. The serum rabies neutralizing antibodies grow positive get earlier（on 7th day） in people groups with the history of rabies vaccination before three years.