2017年河南省健康人群脊髓灰质炎抗体水平监测结果分析

Surveillance of poliovirus antibody levels in the healthy population in 2017 in Henan Province

目的了解河南省健康人群脊髓灰质炎(poliomyelitis,以下简称脊灰)抗体水平,为维持河南省无脊灰提供科学依据。方法采用系统抽样的方法,随机选取河南省2个省辖市(平顶山市、三门峡市)和1个省直管县(兰考县)作为监测点,然后从选取的各个省辖市中随机选取一个县或区作为监测点。每个监测点采取健康人群血标本,通过细胞中和试验检测脊灰I、III型抗体。结果共检测649份健康人血标本,其中脊灰I型和III型抗体阳性率分别为97.53%和88.14%,抗体几何平均滴度(GMT)分别为1∶81.65和1∶26.80。不同年龄组之间脊灰抗体阳性率和GMT差异均有统计学意义(P<0.05),且GMT随着年龄的增加依次减少。不同性别之间脊灰抗体阳性率和GMT差异均无统计学意义(P>0.05)。不同免疫史之间脊灰I型和III型抗体阳性率差异有统计学意义(P<0.05);同时,I型GMT之间差异有统计学意义(P<0.05); III型之间差异无统计学意义(P>0.05);有免疫史的人群抗体阳性率和GMT高于无免疫史或免疫史不详的人群。不同地区之间脊灰I型抗体阳性率差异无统计学意义,I型GMT差异有统计学意义,而III型抗体阳性率差异有统计学意义,III型GMT差异无统计学意义。结论 2017年河南省健康人群脊灰免疫效果整体较好,但是不同地区抗体水平存在差异,因此需对薄弱地区开展脊灰强化免疫和查漏补种工作,维持好河南省无脊灰的状况。

Objective To investigate the poliovirus antibody levels in the healthy population in Henan Province,and to provide a scientific evidence for the maintenance of polio-free status. Methods In this study,a systematic sampling method was used to randomly select two provincial jurisdiction cities and one provincial jurisdiction county,thus the Xinhua District of Pingdingshan City,Lingbao City and Lankao County were selected as the surveillance regions in the Province. Blood samples from healthy populations were taken at each monitoring site and neutralizing antibodies against poliovirus were detected by cell neutralization test. Results A total of 649 human blood samples were tested from healthy population. The positive rates of poliovirus type I and type III antibodies were 97.53% and 88.14%,respectively,and the geometric mean antibody titers（ GMT） were 1 ∶ 81.65 and 1 ∶ 26.80,respectively. There were statistcial differences in the positive rate of poliovirus antibodies and GMT between different age groups（ P 〈0. 01）. GMTs were decreased along with age growing.There was no a statistical difference in the positive rate of polio antibody between different sexes and GMT（ P〉0.05）. There were statistical differences in the positive rates of polio type I and type III antibodies between subjects with different immunization histories（ P〈 0. 05）,there were statistical differences between type I GMT（ P〈0.05）,and there was no a statistical difference between type Ⅲ（ P〉0.05）. The antibody positive rate and GMT in subjects with immunization history were higher than those without immunization history. There was no a statistical difference in the positive rate of poliovirus type I antibody between different regions,and there were statistical differences in type I GMT,while there was a statistical difference in the positive rate of type III antibodies,but there was no a statistical difference in type Ⅲ GMT. Conclusion In2017,the overall effect of poliovirus immunization was under a better controlling level in healthy population in Henan Province,but there were some differences in antibody levels in different regions. Therefore,it is necessary to carry out immunization supplementary activities in the immunization weak regions so as to maintain the state of polio-free in the Province.