2009～2015年天津市健康人群人肠道病毒71型血清中和抗体动态变化研究

Dynamic Change in EV-A71 Neutralizing Antibody in Healthy People Living in Tianjin,China,2009～2015

了解天津市健康人群人肠道病毒71型(EV-A71)中和抗体动态变化,为手足口病防控提供依据。2009~2015年共采集5 654名天津市健康人的血清进行EV-A71中和抗体测定,结果提示EV-A71中和抗体总阳性率为82.03%,5岁及以下年龄组的抗体阳性率最低为68.28%,随着年龄增长,抗体阳性率逐年增加。不同年份、不同区域、不同年龄组间的抗体阳性率差异均有统计学意义。以健康人群EV-A71中和抗体阳性率作为应变量,对健康人群的卫生习惯及环境等进行Logistic回归分析,发现半年内未有医院出入史和饭前洗手是保护性因素。EVA71中和抗体阳性率与病原阳性率呈负相关,第一年的抗体阳性率高,第二年的EV-A71病原阳性率则低。5岁及以下儿童和流动人口较多地区应作为手足口病防控的重点,EV-A71抗体阳性率可以做为估测下一年度EV-A71引起EV-A71手足口病流行趋势的依据。

We wished to investigate the dynamic change of enterovirus 71 neutralizing antibody（EV-A71- NA） among healthy people in Tianjin, and to provide a scientific basis for the prevention and control of hand,foot and mouth disease（HFMD）. A total of 5,654 specimens were collected from healthy people liv- ing in Tianjin from 2009 to 2015. EV-A71 antibody was detected using a neutralization test,and the results analyzed by statistical methods. The positive rate was 82.03% for EV-A71-NA. The lowest positive rate was 68.28% in those age〉5 years,and the positive rate increased with age. A significant different was ob- served in the positive rate with regard to different age groups and areas. We constructed logsitic regression models using the positive rate as an dependent variable, and lifestyle and environment as independent vari- ables. We found the protective factors to be hosipital admission after〉6 months and hand-washing before eating. There was a negative correlation between the positive rate of EV-AT1-NA and positive rate of EV- A71. If the positive rate of EV-AT1-NA was high in the first year, the positive rate of EV-A71 was low in the second year. To prevent and control HFMD, attention should be paid to children under 5 years of age and the areas with transient populations. The subsequent positive rate of EV-AT1-NA can aid judgment of the trend of HFMD by EV-A71 in the subsequent year.