儿童接种麻腮风联合减毒活疫苗的安全性及免疫学疗效观察

Safety and immunological curative effect observation of measles,mumps,and rubella combined attenuated live vaccination in children

目的观察儿童接种麻腮风联合减毒活疫苗的临床安全性以及免疫学疗效。方法随机抽取江西省鹰潭市疾病预防控制中心2016年1~12月进行麻疹、腮腺炎以及风疹减毒活疫苗接种的400例儿童作为研究对象,根据疫苗接种情况进行分组,其中100例儿童进行麻疹减毒活疫苗接种,100例儿童进行腮腺炎减毒活疫苗接种,100例患者进行风疹减毒活疫苗接种,100例儿童进行麻腮风联合减毒活疫苗接种。观察各组儿童接种后30 min内的不良反应(皮疹、发热、恶心呕吐、纳差、腹泻等)发生情况,应用抗体滴度进行免疫学疗效评价,并比较各组儿童的几何平均滴度。结果麻腮风联合减毒活疫苗接种后的不良反应发生率为9.00%(9/100),与其他组比较,差异无统计学意义(P>0.05)。麻腮风联合减毒活疫苗组儿童疾病免疫后风疹的几何平均滴度为1∶31,与风疹疫苗组免疫后的几何平均滴度1∶29比较,差异有统计学意义(P<0.05);麻疹、腮腺炎的几何平均滴度比较,差异无统计学意义(P>0.05)。结论儿童接种麻腮风联合减毒活疫苗的预防效果确切,与单一麻疹疫苗、腮腺炎疫苗以及风疹疫苗相比,不会提高不良反应发生率,临床用药安全可靠,但从免疫学疗效来看,麻腮风联合减毒活疫苗预防接种会导致风疹的几何平均滴度上升,必须引起临床人员的重视。

Objective To observe the clinical safety and immunological curative effect of measles,mumps,and rubella combined attenuated live vaccination in children.Methods A total of 400 children who were vaccinated against measles,mumps and rubella live vaccines were randomly selected from January 2001 to December 2016 in the Center for Disease Control and Prevention of Yingtan City in Jiangxi Province.According to the vaccination grouping,100 cases of children vaccinated against live attenuated measles,100 cases of children with mumps attenuated live vaccination, 100 patients were given rubella live attenuated vaccination,100 cases of children were given measles,mumps,and rubella combined attenuated live vaccination.The incidence of adverse events such as rash,fever,nausea and vomiting,anorexia and diarrhea were observed within 30 min after inoculation.Immunological evaluation was carried out by using antibody titer,and the geometric mean titer of each group was compared.Results The incidence of adverse reactions after inoculation was 9.00% （9/100）,compared with other groups,the difference was not statistically significant （P〉0.05）.The average geometric titers of rubella after immunization in children with measles,mumps,and rubella combined attenuated live vaccination were 1：31,and compared with the average geometric titers of rubella vaccine group （1：29）,there was significant difference （P〈0.05）.There was no significant difference in the average geometric titers between measles and mumps （P〉0.05）.Conclusion The preventive effect of measles,mumps,and rubella combined attenuated live vaccination is definite,compared with single measles vaccine,mumps vaccine and rubella vaccine,there is no increase in the incidence of adverse reactions,and clinical treatment is safe and reliable,but from the point of view of immunological efficacy,measles,mumps,and rubella combined attenuated live vaccination will lead to rubella geometric mean titer rise,and must pay attention to clinical staff.