2019—2020年平顶山市0-14岁健康儿童8种病原血清免疫抗体特征分析

Serological analysis of 8 kinds of pathogen-specific immune antibodies’ characteristics in healthy children aged 0-14 years during 2019-2020 in Pingdingshan City

目的通过分析2019—2020年平顶山市0~14岁健康儿童病原血清免疫抗体特征,了解该人群免疫情况,为进一步做好计划免疫工作提供依据。方法采用分层抽样方法随机抽取本市4个县区0~14岁健康儿童,共采集521份血清样本,用ELISA检测血清中麻疹、风疹、腮腺炎、百日咳、白喉、破伤风、脑膜炎奈瑟菌A群和C群病原血清免疫抗体。结果8种病原血清免疫抗体阳性率差异有统计学意义。5个年龄组中,>1~3岁组麻疹、风疹和腮腺炎抗体阳性率最高,白喉、破伤风抗体阳性率均较高,均≥96.30%。各年龄组百日咳抗体阳性率普遍偏低,≤29.11%。麻疹、风疹、腮腺炎、百日咳、脑膜炎奈瑟菌A群和C群抗体阳性率差异均有统计学意义(均P<0.05);白喉和破伤风抗体阳性率差异均无统计学意义(均P>0.05)。宝丰县的麻疹、百日咳和脑膜炎奈瑟菌A群抗体阳性血清最多。鲁山县风疹抗体阳性率最高,为86.05%。宝丰县和叶县的白喉抗体阳性率均为100.00%。宝丰县、叶县和舞钢市破伤风抗体阳性率均为100.00%。舞钢市的脑膜炎奈瑟菌C群抗体阳性率最高,为42.31%。麻疹、风疹、腮腺炎、脑膜炎奈瑟菌A群和C群抗体的阳性率不同地区间差异均有统计学意义(P均<0.05);白喉、破伤风和百日咳抗体阳性率差异无统计学意义(均P>0.05)。8种病原血清免疫抗体阳性率性别差异均无统计学意义(均P>0.05)。≥2剂次组8种病原抗体阳性率均最高。0剂次健康儿童破伤风抗体阳性率最高,为93.33%。接种1剂次健康儿童白喉和破伤风抗体阳性率较高,分别为95.46%和95.45%。接种≥2剂次健康儿童破伤风和白喉抗体阳性率较高,分别为100.00%和99.17%;百日咳阳性率最低,仅为13.02%。麻疹、风疹、腮腺炎、白喉、破伤风、脑膜炎奈瑟菌A群和C群抗体阳性率各剂次组间差异均有统计学意义(均P<0.05),含百日咳抗体阳性率各剂次组间差异无统计学意义(P>0.05)。结论平顶山市健康儿童群体8种病原血清免疫抗体水平不同,存在种类、年龄和地区差异,须继续加强病原血清免疫抗体水平监测,关注不同抗体低水平人群和地区差异,制定有针对性的疫苗接种策略,及时接种疫苗,降低8种传染病发生风险。

Objective By analyzing the pathogen-specific antibodies’ characteristics of healthy children in Pingdingshan City in year 2019 and 2020, to understand the immune status of this population and provide scientific basis for further immunization planning. Methods A total of 521 serum specimens of healthy children aged 0-14 were randomly selected from 4 counties of the city by stratified sampling method. The serum antibodies to measles, rubella, mumps, pertussis, diphtheria, tetanus, Neisseria meningitidis serogroups A and C were analyzed by enzyme-linked immunosorbent assay(ELISA). Results There were significant differences in the positive rate of immune antibodies against 8 pathogens. Among 5 age group categories, >1-3 age group had the highest positive rate of measles, rubella and mumps antibodies, diphtheria and tetanus antibodies both reached relatively high positive rate(≥96.30%). All age groups’ pertussis antibodies had the relatively low positive rate(≤29.11%);there were significant differences in the positive rates among immune antibodies against measles, rubella, mumps, pertussis, Neisseria meningitidis serogroups A and C(all P<0.05), and there was no difference between diphtheria and tetanus antibodies(all P>0.05). In Baofeng County, measles, pertussis and Neisseria meningitidis serogroup A shared the most positive antibody cases, while positive rate of rubella antibody in Lushan County was the highest(86.05%). The positive rates of diphtheria antibody in Baofeng County and Ye County both were 100.00%. The positive rates of tetanus antibody in Baofeng County, Ye County and Wugang City also reached 100.00%. In Wugang City, the positive rate of antibody against Neisseria meningitidis serogroup C was the highest as 42.31%. The positive rates of antibodies to measles, rubella, mumps, Neisseria meningitidis serogroups A and C were statistically significant among different regions(all P<0.05). There were no significant differences in the positive rates of diphtheria, tetanus and pertussis antibodies(all P>0.05). There was no statistically significant difference in the 8 kinds of pathogen-specific positive rate of immune antibody in terms of gender(P>0.05). The positive rate of 8 kinds of pathogen-specific antibodies was highest in ≥2 doses group. The positive rate of tetanus antibody in 0 dose healthy children group was the highest as 93.33%. The positive rates of antibody against diphtheria and tetanus in one-dose vaccinated children group were 95.46% and 95.45%, respectively. The positive rates of tetanus diphtheria antibody in healthy children vaccinated ≥2 doses were 100.00% and 99.17%, respectively. The positive rate of pertussis antibody was lowest as 13.02%. There were statistically significant differences in the positive rates of measles, rubella, mumps, diphtheria, tetanus and Neisseria meningitidis serogroups A and C antibodies for dose dependent groups(all P<0.05), while there was no statistically significant difference in the positive rates of pertussis antibody for dose dependent groups(P>0.05). Conclusion The levels of 8 kinds of pathogen-specific immune antibodies among healthy children in Pingdingshan City are different based on ages, pathogens and regions. Therefore, it is an urgent need to strengthen monitoring of antibody levels, pay more attentions to areas and populations with low levels of antibodies, and timely vaccination to reduce the risk of vaccine-preventable infectious diseases.