2000年广西麻疹疑似病例血清学监测分析

Serological surveillance and analysis for suspicious cases of measles in Guangxi

目的了解麻疹的血清流行病学特征 ,探讨麻疹与风疹之间的血清学鉴别诊断。方法采用酶联免疫吸附法对714例RFIs的血清标本进行麻疹IgM和风疹IgM抗体检测 ,对204例麻疹IgM抗体阳性的血清标本进行麻疹IgG抗体检测。结果麻疹IgM阳性率为45.7 % ,风疹IgM抗体阳性率为27.5%。在出疹后4～14天采集的血清标本其麻疹IgM和风疹IgM抗体阳性检出率最高。麻疹IgM阳性数以1～14岁为主 ,1～6岁最高 (44.5% ) ,风疹IgM阳性数是7～14岁为最高 (73.5% ) ;麻疹IgG检出<1:200为76例 (27.7 % ) ,1:200为59例 (21.5% ) ,1:800为17例(6.2 %) ,1:3200为25例(9.1 %) ,≥1:12800为27例(9.8 %)。结论采血时间与检出率密切相关 ;采集血清标本要注意质量和采集时间 ;麻疹患者与风疹患者有一定的年龄差距 ,风疹是最主要的需要与麻疹相鉴别的RFIs,未经实验室诊断极易发生误诊 ;应提高麻疹实验室诊断的及时性、准确性和敏感性 。

Objective To understand the seroepidemiological character of measles and study the serodiagnosis between measles and rubella. Methods Captured_ELISA was used to test the measles IgM and rubella IgM antibody of acute phase serum specimens of RFIs and measles IgG of 204 serum specimens whose measles IgM antibody was positive.Results The positive rates of measles IgM and rubella IgM antibody were 45.7%,and 27.5% respectively,the positive rates of measles IgM and rubella IgM antibody were both the highest in 4～14 days after rash.The highest positive rates(44.5%)of measles IgM antibody was in the range of 1～6 years old,however,the highest positive rates(73.5%) of rubella was in the range of 7～14 years old.The measles IgG antibody titers were <1:200 ,76 cases(27.7%);1:200,59 cases(21.5%);1:800,17 cases(6.2%);1:3200,25 cases(9.1%);≥1: 12800,27 cases(9.8%). Conclusion The serodiagnosis is a scientific and convenient method to distinguish RFIs.There is a significant correlation between the positive ratie and the date of specimens collected after rash.The age range of measles patients and rubella patients are different.Rubella is one of the important RFIs,which often needs to be distinguished from measles,so, we should improve the accuracy,promptitude and sensitivity of our laboratory,we also suggest that measles serodiagnosis should be developed in some areas with facilities. [