深圳市罗湖区109对母婴配对麻疹母传抗体水平研究

Maternal delivered measles antibody in 109 maternal and infant pairs in Luohu District,Shenzhen City

目的了解孕妇及其新生儿麻疹抗体水平，探讨新生儿与孕母麻疹抗体水平的关系以及新生儿抗体随时间变化的规律，为控制小月龄儿童发病提供建议。方法2013—2015年间，采集罗湖区109名孕妇产前静脉血及其新生儿脐带血、新生儿3月龄87例、5月龄79例、7月龄63例静脉血，使用ELISA方法进行麻疹IgG检测。结果新生儿麻疹抗体几何平均浓度（四肥）1001．39mlU／ml，是母血抗体浓度（646．28mlU／m1）的1．55倍（t配对=9．368，P〈0．001）。3、5、7月龄时麻疹抗体几何平均浓度（GMC）分别下降到161．63、125．61、112．91mlU／ml。母血抗体阳性率（85．3％）和保护率（45．0％）均低于脐带血（χ2=39．176、35．821，P〈0．001），出生后抗体阳性率和保护率均逐月下降（趋势检验，χ2阳性率=115．618，P〈0．001；χ2保护率=109．441，P〈0．001）。64．22％的对子，母血和脐血抗体在同一浓度水平。母血抗体对数浓度和脐带血、3、5、7月龄血抗体对数浓度均呈正相关（r1=0．897，t=20．942，P〈0．001；r2=0．768，t=11．045，P〈0．001；r3=0．574，t=6．154，P〈0．001；r4=0．257，t=2．074，P=0．042）。结论新生儿出生后麻疹抗体衰减，而母亲抗体水平决定着新生儿的抗体水平，当前开展针对育龄妇女的麻疹疫苗接种，通过提高母亲抗体水平继而提高新生儿麻疹抗体水平，是控制小月龄婴儿罹患麻疹的重要途径。

Objective To know the levels of measles antibodies in newborns and their mothers, to explore their relationships and their change rule in infants, so as to provide reference for the control of measles incidence in young infants. Methods In 2013 - 2015, antenatal venous blood was collected from 109 pregnant women in Luohu District. Their infants were followed up, and blood was collected from umbilical cords of 109 infants at birth, 87 infants at age of three months, 79 infants at age of five months and 63 infants at age of seven months. The measles IgG antibody was tested by ELISA. Its detection rate was compared by chi - square test and its geometric mean concentration （GMC） was compared by variance analysis and t - test. Results The GMC of neonatal measles IgG antibody （1001.39mIU/ml） was 1.55 times of that of maternal one （646.28mIU/ml）, showing significant difference （paired t = 9. 368, P 〈 0. 001 ）. The GMC decreased to 161.63mIU/ml, 125.61mIU/rnl and 112.91mIU/ml in 3, 5 and 7 - month aged infants respectively. Both the positive rate and protective rate of the measles IgG an- tibody were significantly lower in the mothers than in the newborns （ χ2 = 39. 176, P 〈 0.001 ;χ2 = 35. 821, P 〈 0. 001 ）. And both decreased monthly after birth（χ2positive rate=115. 618, P〈0. 001; ）χ2positive rate= 109.441, P〈0.001）. 64.22% of the pairs shared the same antibody level. The maternal logarithmic concentration of measles antibody was positively correlated with the log- arithmic concentrations in newborns, 3, 5 and 7 - month aged babies,and the correlation coefficients were 0. 897, 0. 768, 0. 574 and 0. 257 respectively. Conclusions The measles antibody of infants is attenuated after birth. The maternal measles anti- body level is the key influencing factor. Therefore, enhancing measles vaccine immunization in women of child- bearing age is an important way to control the onset of measles in infants.