2015年云南省20岁及以上常住居民麻疹抗体水平与易感性分析

Analysis of measles immunity level and serological susceptibility among Yunnan residents aged≥20 years

目的 评价云南省20岁及以上人群麻疹抗体水平,探讨成年人麻疹易感的影响因素.方法 于2015年6—9月,在云南省采用多阶段分层系统随机抽样的方法,在全省抽取42个县（市、区） 252个村（居）委会共2689名20岁及以上常住居民作为调查对象,使用统一的问卷收集调查对象基本信息、含麻疹成分疫苗免疫史和麻疹患病史;并采集静脉血5 ml,采用ELISA检测血清中麻疹IgG抗体水平,抗体几何平均浓度（GMC）≥250 mU/ml为阳性,〈250 mU/ml为阴性.应用非条件多因素logistic回归模型分析影响调查对象麻疹易感的因素.结果2689名调查对象的麻疹抗体GMC为810.20 mU/ml,麻疹抗体阳性率为89.77%（2414例）.多因素分析显示,与经济状况差的地区人群相比,经济状况中等地区人群易感麻疹的OR（95%CI）值为1.81（1.33~2.47）;与≥40岁组人群相比,其余4个年龄组人群麻疹易感的OR（95% CI）值分别为20~24岁[2.04（1.26~3.31）]、25~29岁[3.72（2.37~5.86）]、30~34岁[1.94（1.22~3.09）]、35~39岁[1.81（1.07~3.05）].结论 云南省20~39岁人群,尤其经济状况中等的地区人群麻疹易感的危险性较高,建议增加成年人接种含麻疹成分疫苗的机会,最大限度减少免疫空白.

Objective To evaluate the population immunity to measles and explore the factors associated with measles susceptibility in Yunnan residents aged ≥20 years. Methods 2 689 residents aged≥20 years were selected by multistage stratified systematic randomized sampling in 252 villages of 42 counties in Yunnan Province between June and September in 2015.Each subject was surveyed by the same questionnaire, including general information, measles contained vaccine history, measles history, and 5 ml blood sample of each subject was collected.Serum IgG antibodies against measles virus were measured by ELISA. Positive was defined as the antibody concentration ≥250 mU/ml, and negative as 〈250 mU/ml. Non-conditional logistic regression model was used analyze the factors associated with measles susceptibility in adults. Results Among 2 689 subjects, 1 214 were males （45.15%）, and the overall positive rate of measles IgG antibody was 89.77%.Compared with subjects from the region where economic development was low, subjects from the region where economic development was moderate were likely to be susceptible to measles virus（OR=1.81,95%CI：1.33-2.47）.Four age groups had higher risk of being susceptible to measles virus（compared with≥40 years：20-24 years old,OR=2.04,95%CI：1.26-3.31;25-29 years old,OR=3.72, 95% CI： 2.37-5.86; 30-34 years old, OR=1.94, 95% CI： 1.22-3.09; 35-39 years old, OR=1.81, 95% CI：1.07-3.05）. Conclusion Our results suggest that the serological susceptibility in adults （20-39 years）, especially adults from the regions where the economic development was moderate,should be concerned.The additional vaccination strategy targeting young adults is important for reducing the risk of measles infection.