儋州市适龄儿童白喉、麻疹和乙脑抗体水平监测分析

Analysis of monitoring of diphtheria,measles and Japanese encephalitis antibody levels of school-age children in Danzhou city

目的了解儋州市适龄儿童接种疫苗后的免疫状况,评价免疫接种服务质量和水平,为制定免疫预防策略和工作方案提供科学的依据。方法通过随机自愿原则,对全市989名1~4岁儿童开展百白破疫苗（DPT）、含麻疹病毒成分疫苗（MCV）和乙脑疫苗（JEV）（以下简称＂三苗＂）接种率调查。同时采集被调查者末梢血20μL送实验室,检测血清白喉IgG抗体、麻疹IgG抗体和乙脑IgG抗体水平,比较儋州市适龄儿童＂三苗＂接种率与相关抗体之间的水平及分析影响因素。结果被调查的989名儿童DPT、MCV、JEV接种率达到98%以上,白喉、麻疹和乙脑抗体阳性率分别为86.75%、95.35%和84.43%;麻疹抗体阳性率在各年龄组间差异无统计学意义（P〉0.008）,白喉和乙脑抗体阳性率在各年龄组间差异有统计学意义（P〈0.008）;DPT3针和DPT4针接种后白喉抗体阳性率分别达到78.43%和89.13%,MCV1针和MCV2针接种后麻疹抗体阳性率分别为91.57%和96.35%,JEV1针和JEV 2针接种后乙脑抗体阳性率分别为73.82%和88.86%,DPT、MCV和JEV初种与复种抗体阳性率间差异均有统计学意义（P〈0.05）。结论儋州市适龄儿童＂三苗＂总接种率较高,但部分地区抗体阳性率仍较低,需要进一步加强免疫规划接种工作的管理,提高接种人员的责任心、规范疫苗的接种。

Objective To understand the immunization status of children after vaccination and to evaluate the quality andlevel of immunization services,so as to provide scientific basis for formulation of immune prevention strategy and plans.Methods The vaccination rates of diphtheria, pertussis, tetanus vaccine（DPT） containing measles virus vaccine（MCV） andJapanese encephalitis vaccine（JEV） of 989 1-4 year-old infants in danzhou city were surveyed on random and voluntary basis,at the same time 20μL peripheral blood were collected and sent to the laboratory for enzyme linked immunosorbent assay（ELISA） and the levels of serum diphtheria IgG, measles IgG antibody and JE IgG antibodies were detected. Then therelationship between vaccination rates of three vaccines and antibody levels of the school- age children in Danzhou wasinvestigated and the influencing factors were also analyzed. Results The vaccination rate of DPT, MCV and JEV of the 989 children surveyed were over 98% while the positive rates of diphtheria, measles and JE antibodies were 86.75%,95.35% and84.43%,respectively. The positive rates of measles antibody in all age groups showed no statistical significance（P 〉0.008）, thedifferences between the diphtheria and JE antibody positive rates revealed statistical significance（P 〈0.008）.The positive ratesof diphtheria reached 78.43% and 89.13% respectively after thr third and fourth injection of DPT vaccine, the positive rates ofmeasles antibody were 91.57% and 96.35% respectively after the first and second infection of JEV,the positive rates of JEantibody reached 73.82% and 88.86% after the first and second injection of JEV.The positive rates between the initial andsecond vaccinations of DPT, MCV and JEV showed statistical significance（P 〈0.05）. Conclusion The vaccination rates ofDPT,MCV and JEV of the school-age children in Danzhou were high. But the positive rate of antibody in some areas was stillrelatively low,thus the management of immunization program be strengthened, the responsibility of the staff of the vaccinationenhanced and the vaccination activity be standardized.