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目的了解土拉弗氏菌病患者免疫力维持时间、影响因素及一般人群中隐性感染情况。方法分别于发病后3周,6个月,2,3,6,7,8,9,20年采集血清,对山东省胶南县原外贸冷藏厂的31名土拉弗氏菌病患者及同地区一般人群进行纵向队列研究,检测血清中土拉弗氏菌特异性抗体,当效价>1∶40时为阳性;并于2005年对其发病状况和行为习惯等进行回顾性调查。结果病例组抗体几何平均滴度(GMT)从1986年的11890.00逐年下降到2005年的46.94,抗体效价衰减率为59.1%。早期抗体水平与后期抗体水平相关分析系数r=0.659(P<0.05),二者呈正相关。问卷调查表明,发病状况和行为习惯等与后期抗体水平的差异无统计学意义(P>0.05)。对照组历年来均为阴性。结论部分患者血清的土拉弗氏菌特异性抗体可长期存在,并呈逐渐下降趋势,而且后期抗体水平很大程度上受早期抗体效价高低的影响,与其他因素无关。一般人群无隐性感染。
Objective To understand the immune maintenance time, influencing factors and recessive infection in the general population of patients with TURD. Methods Serum was collected at 3 weeks, 6 months, 2, 3, 6, 7, 8, 9 and 20 years after onset, respectively. Twenty-one patients with TURD in Tongyuan County, Shandong Province, Longitudinal cohort study was conducted in the general population in the region to detect Taulura specific antibodies in serum, which was positive when the titer was> 1:40. A retrospective survey was conducted on its morbidity and behavior in 2005. Results The geometric mean titer (GMT) of antibody decreased from 11890.00 in 1986 to 46.94 in 2005, and the antibody titer decay rate was 59.1%. The correlation coefficient between early antibody level and late antibody level was r = 0.659 (P <0.05), and there was a positive correlation between them. The questionnaire survey showed that there was no significant difference between late onset antibody status and incidence and behavior habit (P> 0.05). The control group was negative over the years. Conclusions The serum levels of specific antibodies to Tulauvara in some patients may exist for a long period of time and show a gradual downward trend. Moreover, the level of antibody in late stage is largely affected by the antibody titer of early antibody, which has nothing to do with other factors. No hidden infection in the general population.