吉林省2009～2014年麻疹病例含麻疹成分疫苗免疫史对临床特征的影响

Measles Vaccination History Association with Clinical Features of Measles Cases in Jilin Province,2009-2014

目的分析吉林省2009-2014年麻疹病例含麻疹成分疫苗（Measles-containing Vaccine,MCV）免疫史对临床特征的影响。方法收集吉林省2009-2014年麻疹监测系统报告的麻疹确诊病例,采用描述流行病学方法分析年龄及MCV免疫史;选择实验室确诊麻疹病例,剔除免疫史不详病例后将病例分为0剂与≥1剂组,运用逻辑斯谛（Logistic）回归分析MCV免疫史对临床特征的影响。结果 Logistic回归分析结果显示,与0剂MCV免疫史麻疹病例相比,≥1剂MCV免疫史麻疹病例发生咳嗽的比值比（Odds Ratio,OR）为0.514[95%可信区间（Confidence Interval,CI）为0.369-0.714,P〈0.05）,发生口腔黏膜斑的OR值为0.451（95%CI：0.386-0.529,P〈0.05）,结论≥1剂MCV免疫史麻疹病例发生咳嗽和口腔黏膜斑较0剂MCV免疫史麻疹病例轻,接种MCV对降低发病风险、减轻临床症状有重要意义。

Objective To determine the association of measles-containing vaccine（ MCV） vaccination history of measles cases reported in 2009-2014 with clinical characteristics of measles,and to discuss the importance of MCV. Methods We obtained complete immunization histories from measles cases from the measles surveillance system for analysis,and we used epidemiological methods to describe age and history of MCV distribution. For analysis,we selected measles cases that had been confirmed by laboratory testing. Cases with unknown vaccination histories were excluded; the study cases were categorized into0 and ≥1 dose groups. We used single factor logistic regression to assess the impact of MCV history on clinical features of measles. Results Logistic regression analysis showed that the relationships between vaccination history and clinical symptoms or signs were statistically significantly different between the 0and ≥1 dose groups on cough [odds ratio（ OR） = 0. 514,95% confidence interval（ CI） ： 0. 369-0. 741,P 〈0. 05 ],and for Koplik spots（ OR = 0. 451,95% CI： 0. 386- 0. 529,P 〈0. 05）. Conclusions Clinical symptoms of measles were typical. Symptoms of cough and Koplik spots were less frequent among ≥1 dose group than that among those unvaccinated. MVC should be implemented for reducing the risk and the clinical symptoms of measles.