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目的探讨育龄妇女孕前接种麻疹疫苗(MV)的时机对8月龄内婴儿麻疹抗体水平的影响。方法选取2013年1月-2015年5月在东莞市长安医院和长安镇社区卫生服务中心进行婚前检查的976名育龄妇女为观察对象,根据孕前接种MV时间的不同,分为三组,Ⅰ组(孕前3~6个月接种)、Ⅱ组(孕前7~12个月接种)、Ⅲ组(孕前>12个月接种),孕妇于接种前、接种后一个月、分娩时采集血清,分娩时采集脐带血,测定麻疹IgG抗体水平,分析三组孕妇接种前、接种后一月麻疹IgG抗体水平、麻疹IgG抗体阳性率及麻疹保护性抗体阳性率的变化和组间差异及母婴麻疹IgG抗体阳性率、保护性抗体阳性率及抗体滴度的相关性。结果项目成功收集符合条件并成功分娩的630例孕妇的相关资料,Ⅰ组、Ⅱ组和Ⅲ组各210例。三组间孕妇接种前、接种后一月的麻疹IgG抗体水平、麻疹IgG抗体阳性率及麻疹保护性抗体阳性率的比较差异无统计学意义(P>0.05)。各组接种后一月的麻疹IgG抗体水平、麻疹IgG抗体阳性率及麻疹保护性抗体阳性率均较接种前显著升高(P<0.05)。分娩时三组母亲及所产新生儿麻疹IgG抗体阳性率比较差异有统计学意义(P<0.05),两两比较发现,Ⅰ、Ⅱ组母亲及所产新生儿麻疹IgG抗体阳性率及麻疹保护性抗体阳性率差异均显著高于Ⅲ组(P<0.017)。新生儿抗体水平随母亲抗体水平升高而升高,两者之间呈正相关(Pearson相关系数=0.999,P=0.020)。结论孕前3~12个月内育龄妇女接种MV,能明显提高婴儿麻疹抗体水平。
Objective To investigate the impact of the timing of prenatal immunization on the antibody level of measles in 8-month-old pregnant women of childbearing age. Methods A total of 976 women of childbearing age who had premarital examination in Chang’an Hospital and Chang’an Community Health Service Center from January 2013 to May 2015 were selected as observation subjects and divided into three groups according to the time of preimpregnation. (3 to 6 months prior to inoculation), group II (7 to 12 months before inoculation), group III (12 months before inoculation), pregnant women before vaccination, one month after inoculation, and serums were collected during childbirth Umbilical cord blood was collected and measles IgG antibody levels were measured. The levels of measles IgG antibody, the positive rate of measles IgG antibody and the positive rate of measles protective antibody before immunization and the month after inoculation were analyzed. Positive rate, the positive rate of protective antibodies and antibody titers. Results The data of 630 pregnant women who met the criteria and were successfully delivered were collected successfully. The patients in group Ⅰ, group Ⅱ and group Ⅲ each had 210 cases. Measles IgG antibody level, measles IgG antibody positive rate and measles protective antibody positive rate in the three groups before inoculation were no significant difference (P> 0.05). Measles IgG antibody level, measles IgG antibody positive rate and measles protective antibody positive rate in each group after inoculation were significantly higher than those before inoculation (P <0.05). The positive rate of measles IgG antibody in three groups of mothers and neonates during delivery was statistically different (P <0.05). The positive rates of measles IgG antibody and measles protection The positive rate of antibody was significantly higher than that of group Ⅲ (P <0.017). Neonatal antibody levels increased with elevated levels of maternal antibodies, with a positive correlation (Pearson correlation coefficient = 0.999, P = 0.020). Conclusions In women of childbearing age vaccinated with MV within 3 ~ 12 months before pregnancy, the measles antibody level of infants can be obviously increased.