上海市1~8月龄小儿麻疹抗体水平消长分析

Establishment of a mathematical model for the analysis of anti-measles antibody reduction trend in children aged 1-8 months

【目的】了解1~8月龄小儿麻疹抗体水平及其消减趋势,建立数理模型,为控制低月龄儿麻疹发病提供依据。【方法】采用横断面研究方法,在上海市某儿童医学中心收集1~8月龄小儿血清,采用酶联免疫吸附法(ELISA)检测麻疹IgG抗体水平,并予以动态比较分析。【结果】共检测1~8月小儿麻疹抗体827例,男性467例,女性360例,男女之间抗体水平差异无统计学意义(P>0.05);1月龄时,麻疹抗体几何平均浓度(GMC)为529.66 IU‧L^(−1),抗体阳性率、保护率分别为86.07%、29.51%;3月龄时抗体水平出现陡降,8月龄时GMC为44.46 IU‧L^(−1),阳性率为12.73%,保护率为1.00%;GMC消减趋势数理模型为Ŷ=−0.1448X+2.640(R^(2)=0.9113,P<0.001)。【结论】母传抗体水平随月龄呈现下降趋势是导致1~8月龄小儿麻疹发病的重要原因。随着国家三孩政策的放开,建议加强对育龄女性开展强化免疫,并纳入计划免疫工作日程。

[Objective]To determine the level of anti-measles antibody and its fluctuation trend in children under 8 months old,which may provide evidence for enhancing the measles immunization strategy.[Methods]A cross-sectional study was conducted to collect the serum of the children aged 1‒8 months in a children’s medical center in Shanghai.Serum concentration of anti-measles IgG antibody was determined by enzyme-linked immunosorbent assay(ELISA),and dynamics of IgG antibody level was compared.[Results]A total of 837 children aged 1‒8 months were tested for anti-measles antibody,and there was no statistical difference in the antibody level between boys and girls(P>0.05).In the age of 1 month children,the average geometric antibody concentration(GMC)was 529.66 IU‧L^(−1),and the antibody positive rate and protection rate were 86.07%and 29.51%respectively.After the age of 3 months,the antibody level dropped sharply in the age of 8 months children,the GMC decreased to 44.46 IU‧L^(−1).The positive rate was 12.00%,and the protection rate was 1.00%.The mathematical model of GMC reduction trend in children aged 1‒8 months wasŶ=−0.1448X+2.640(R^(2)=0.9113,P<0.001).[Conclusion]The low level of mothertransmitted protective antibody and its downward trend with age are the important factors leading to the incidence of measles in children aged 1‒8 months.It is suggested that intensive immunization should be carried out for women of childbearing age to improve the level of mothertransmitted antibodies in her baby.