上海市某城区1~14岁人群麻疹疫苗抗体水平消减模型建立与分析

Attenuation of anti-measles antibody in the healthy population aged 1-14 years old in an urban district,Shanghai

【目的】了解上海市1~14岁健康人群麻疹疫苗免疫水平情况及其消减趋势,预测成年人群发病风险,为针对性制定麻疹强化免疫策略提供依据。【方法】采用横断面研究,在上海市某城区医院收集2016—2018年儿科门诊及住院病历中1~14岁上海市户籍健康人群血清,采用酶联免疫吸附实验(ELISA)检测麻疹IgG抗体浓度,并予以动态比较分析。【结果】1~14岁健康人群血清麻疹抗体阳性率为95.29%,抗体保护率为61.86%,几何平均滴度(GMT)2.9576(抗体水平为906.98 mIU/mL),男女之间抗体水平分布差异均无统计学意义(P>0.05)。在不同年龄组之间,抗体水平随着年龄增长呈下降趋势(P<0.05),10岁以后抗体水平下降较为明显,13~14岁时阳性率为87.41%,保护率仅为22.96%,GMT为2.6671(抗体水平为464.62 mIU/mL)。根据抗体GMT水平随年龄消减的拟合模型Y(回归)=3.217-0.04X(R2=0.943,P<0.05),预测19~20岁时抗体水平保护率几乎为0、29~30岁时抗体水平阳性率几乎为0。【结论】在几乎无麻疹自然感染的情况下,接种麻疹疫苗后,疫苗抗体浓度随着年龄的增长呈现直线下降的趋势,10岁以后下降较为明显,15岁以后处于较低的水平。为控制成年人口未来的麻疹发病,建议对10~15岁人群进行强化免疫,并将其列为麻疹防控工作的重点对象。

[Objective]To determine the level of anti-measles antibody in healthy population aged 1-14 years old in Shanghai,and project the risk of measles incidence in adult population in the future,which may provide evidence for enhancing the measles immunization strategy.[Methods]A cross-sectional study was conducted to collect the serum of healthy people aged 1-14 years old in an urban district hospital in Shanghai.Serum concentration of anti-measles IgG antibody was examined by enzyme-linked immunosorbent assay(ELISA)and dynamics of IgG antibody was compared.[Results]The prevalence of anti-measles antibody in healthy people aged 1-14 years old was determined to be 95.29%,and the antibody protection rate was 61.86%.There was no significant difference in the distribution of antibody between men and women(P>0.05).However,there was statistical difference in the distribution of antibody among different age groups(P<0.05),in which the antibody showed a decreasing trend with age,especially after the age of 10 years.The lowest prevalence of anti-measles antibody and protection rate were observed in the population aged 13-14 years old,which were 87.41%and 22.96%,respectively.The GMT was 2.6671(equal to the concentration of anti-measles IgG antibody being 464.62 mIU/mL).According to the fitting model Y=3.217-0.04X(R2=0.943,P<0.05),the antibody protection rate was projected to decrease to zero in the population aged 19-20 years old,whereas the anti-measles antibody was to zero in the population aged 29-30 years old.[Conclusion]As there is almost no natural infection of measles,the anti-measles antibody after measles vaccine immunization showed a linearly decreasing trend with age after measles immunization.It is recommended that people aged 10-15 years should be administered intensive immunization for prevention of adults measles,which could be incorporated into current measles immunization strategies.