大连市自然人群风疹免疫屏障建立情况调查

Survey on establishment of rubella immune barrier in natural population in Dalian City

目的了解大连市自然人群风疹免疫球蛋白G(IgG)抗体水平,评估风疹免疫屏障建立情况,为制定消除策略提供依据。方法采用分层随机抽样方法,于2017年3-6月对大连市9个区(县)的自然人群进行抽样调查及血清标本的采集,应用酶联免疫吸附法(ELISA)检测血清标本风疹IgG的几何平均浓度(GMC),分析人群风疹免疫屏障建立情况及抗体阳性率及GMC分布。结果共调查2430人,其风疹抗体总阳性率为75.31%,GMC为73.40 IU/mL。不同地区、年龄、职业、风疹类疫苗(RCV)免疫史人群的风疹抗体阳性率和GMC差异均有统计学意义(均P<0.01)。育龄期女性风疹GMC(75.53 IU/mL)高于非育龄期女性(70.02 IU/mL),差异有统计学意义(Z=180066.50,P<0.01)。结论大连市自然人群维持消除状态的风疹免疫屏障尚未建立,存在小范围风疹持续传播的风险。随着RCV纳入国家免疫规划时间的不断积累,自然人群的整体风疹免疫水平也随之提高。建议继续巩固免疫规划中的RCV接种策略,针对薄弱地区、薄弱人群组织RCV补充免疫活动,对育龄期女性开展RCV接种指导。

Objective To understand the level of rubella IgG antibody in natural population of Dalian City, evaluate the establishment of rubella immune barrier, and provide basis for formulating elimination strategies. Methods A stratified random sampling method was used to perform the sampling survey and collection of serum samples among natural population in nine districts(counties) of Dalian City from March to June 2017. Geometric Mean Concentration(GMC) of rubellaIgG in serum samples was detected by enzyme-linked immunosorbent assay(ELISA). The establishment of rubella immune barrier, the positive rate of antibody and the distribution of GMC in the population were analyzed. Results Totally 2 430 people were investigated. The total positive rate of rubella antibody was 75.31% and the GMC was 73.40 IU/mL. The differences in positive rate of rubella antibody and GMC were statistically significant among different groups in region, age, occupation and immune history of rubella vaccine(RCV)(all P<0.01). The GMC of rubella in women of childbearing age(75.53 IU/mL) was higher than that in women of nonchildbearing age(70.02 IU/mL), and the difference was statistically significant(Z=180 066.50, P<0.01). Conclusion The rubella immune barrier of the natural population in Dalian City has not been established, and there is a risk of continuous transmission of rubella in a small area. With the accumulation of time for RCV to be included in the national immunization program, the overall rubella immunization level of the natural population will also be improved. It is suggested that the strategy of RCV vaccination in immunization program should be strengthened, and RCV supplementary immunization activities should be organized for vulnerable areas and vulnerable groups, and RCV vaccination guidance should be given to women of childbearing age.