2020－2021年湖南省健康人群麻疹抗体水平及影响因素分析

赖智维; 刘雨阳; 辜强; 何建艳; 吴紫玲; 邹金明; 曾晖; 蒋周祥; 方明礼

doi:10.3784/jbjc.202304170172

2020－2021年湖南省健康人群麻疹抗体水平及影响因素分析

doi: 10.3784/jbjc.202304170172

赖智维^1,,
刘雨阳¹,
辜强²,
何建艳³,
吴紫玲⁴,
邹金明⁵,
曾晖⁶,
蒋周祥⁷,
方明礼^1, ,

1.
湖南省疾病预防控制中心, 湖南长沙 410005
2.
宁乡市疾病预防控制中心, 湖南长沙 410600
3.
攸县疾病预防控制中心, 湖南株洲 412300
4.
隆回县疾病预防控制中心, 湖南邵阳 422200
5.
桃江县疾病预防控制中心, 湖南益阳 413400
6.
桂阳县疾病预防控制中心, 湖南郴州 424400
7.
靖州县疾病预防控制中心, 湖南怀化 418400

详细信息

作者简介:
赖智维，男，湖南省炎陵县人，硕士，主管医师，主要从事免疫规划相关疾病监测工作，Email:laizw2016@126.com

通讯作者:
方明礼，Tel：0731–84305721，Email：44302310@qq.com

中图分类号: R211；R186
计量
- 文章访问数: 146
- HTML全文浏览量: 75
- PDF下载量: 19
- 被引次数: 0
出版历程
- 收稿日期: 2023-04-17
- 网络出版日期: 2023-08-09
- 刊出日期: 2023-11-07

Measles antibody level and related factors in healthy population in Hunan, 2020−2021

1.
Hunan Provincial Center for Disease Control and Prevention, Changsha 410005, Hunan, China
2.
Ningxiang Center for Disease Control and Prevention, Changsha 410600, Hunan, China
3.
Youxian Center for Disease Control and Prevention, Zhuzhou 412300, Hunan, China
4.
Longhui Center for Disease Control and Prevention, Shaoyang 422200, Hunan, China
5.
Taojiang Center for Disease Control and Prevention, Yiyang 413400, Hunan, China
6.
Guiyang Center for Disease Control and Prevention, Chenzhou 424400, Hunan, China
7.
Jingzhou Center for Disease Control and Prevention, Huaihua 418400, Hunan, China

More Information

Corresponding author: Fang Mingli, Email: 44302310@qq.com

摘要

摘要: 目的了解湖南省健康人群麻疹抗体水平，分析其影响因素。方法采用多阶段分层随机抽样的方法，2020—2021年在湖南省6个县（区）健康人群共调查3290人并采集血标本，采用酶联免疫吸附法定量检测麻疹IgG抗体水平，运用χ²检验比较各组人群抗体阳性率，方差分析比较各组抗体几何平均浓度（GMC），多因素logistic回归分析抗体阳性的影响因素，多重线性回归分析抗体GMC的影响因素。结果湖南省健康人群麻疹IgG抗体总阳性率为75.08%，抗体GMC为426.67 mIU/mL。抗体阳性率和抗体GMC在地区、年龄组、含麻疹成分疫苗（MCV）接种剂次数、末次MCV接种时间间隔等因素差异均有统计学意义（P<0.05）。多因素logistic回归分析显示，年龄组、MCV接种剂次数是抗体阳性的影响因素。多重线性回归分析显示，末次MCV接种时间间隔是有MCV接种史健康人群抗体GMC的影响因素，抗体GMC随时间间隔的增加而下降（β=−192.386，95% 置信区间：−270.986，−113.785）。结论湖南省健康人群麻疹IgG抗体阳性率和抗体GMC偏低，建议继续保持和提高适龄儿童MCV的及时和全程接种率，必要时对重点地区和重点人群开展补充免疫。
- 麻疹 /
- 抗体水平 /
- 健康人群
Abstract: Objective To understand the measles antibody level and related factors in healthy population in Hunan province. Methods A total of 3290 healthy persons were selected from 6 counties in Hunan during 2020−2021 through multistage stratified random sampling. Blood samples were collected from them for the detection of measles IgG antibody with enzyme-linked immunosorbent assay. The positive rate and geometric mean concentration (GMC) of measles IgG antibody were calculated and analyzed. The influencing factors of measles IgG antibody positive rate were identified by using the multivariate logistic regression analysis. The influencing factors of measles IgG antibody GMC were identified by using the multiple linear regression analysis. Results The positive rate of measles IgG antibody was 75.08% and the measles IgG antibody GMC was 426.67 mIU/mL in healthy population in Hunan. The differences in the positive rate and GMC were significant among different areas, age groups, measles containing vaccine (MCV) dose groups, and peoples with different intervals from last MCV dose (P<0.05). Multivariate logistic regression showed that age, and MCV dose were factors for positive rate of measles IgG antibody. Multiple linear regression analysis showed that the interval from last MCV dose was factor for measles IgG antibody GMC in people with MCV vaccination. Conclusion The positive rate and GMC of measles IgG antibody were generally low in healthy population in Hunan during 2020−2021. We should maintain high coverage of timely 2 doses of MCV immunization in age-eligible children. Effective measles supplementary immunization activity should be carried out in key places and populations if necessary.
- Measles /
- Antibody level /
- Healthy population

HTML全文

表 1 2020－2021年湖南省健康人群麻疹IgG抗体水平

Table 1. Levels of measles IgG antibody in healthy population in Hunan, 2020−2021

变量	调查数（人）	阳性数（人）	抗体阳性率（%）	χ²值	P值	抗体GMC （mIU/mL）	F值	P值
地区				113.176	<0.001		23.429	<0.001
宁乡市	350	303	86.57			565.95
攸县	702	476	67.81			408.75
隆回县	700	552	78.86			446.45
桃江县	350	242	69.14			331.95
桂阳县	820	671	81.83			536.64
靖州县	368	226	61.41			247.33
性别				1.329	0.259		0.322	0.571
男性	1704	1265	74.24			423.24
女性	1586	1205	75.98			430.39
年龄组（岁）				172.170	<0.001		29.100	<0.001
<1	459	248	54.03			260.13
1～	504	429	85.12			667.54
3～	463	384	82.94			550.52
5～	465	366	78.71			449.34
7～	492	356	72.36			329.01
15～	434	303	69.82			329.16
≥20	473	384	81.18			527.08
MCV接种剂次数（剂）				121.566	<0.001		19.006	<0.001
0	344	178	51.74			216.47
1	440	349	79.32			547.47
≥2	1656	1315	79.41			467.65
不详	850	628	73.88			412.78
合计	3290	2470	75.08			426.67
注：GMC. 几何平均浓度；MCV. 含麻疹成分疫苗

下载: 导出CSV

表 2 2020－2021年湖南省健康人群在不同末次含麻疹成分疫苗接种时间间隔的麻疹IgG抗体水平比较

Table 2. Measles IgG antibody level of different interval from last measles-containing vaccine dose in healthy population in Hunan, 2020−2021

末次MCV接种时间间隔（年）^a	调查数（人）	阳性数（人）	抗体阳性率（%）	抗体GMC （mIU/mL）
<1	636	516	81.13	601.20
1～	494	417	84.41	577.09
3～	434	335	77.19	433.81
5～	324	227	70.06	318.56
≥10	208	169	81.25	390.83
合计	2096	1664	79.39	483.11
注：GMC.几何平均浓度；MCV.含麻疹成分疫苗；a. 末次MCV接种时间间隔=采血日期－最近1剂次MCV接种日期；MCV接种剂次数为0剂和不详者未纳入分析

下载: 导出CSV

表 3 2020－2021年湖南省健康人群麻疹IgG抗体阳性率多因素logistic回归分析

Table 3. Multivariate logistic regression analysis of measles IgG antibody positive rate in healthy population in Hunan, 2020−2021

变量	β	$s_{\bar x}$	Wald χ²值	P值	比值比（95%CI）
变量	β	$s_{\bar x}$	Wald χ²值	P值	比值比（95%CI）	年龄组（岁）^a
1～	1.386	0.204	46.318	<0.001	3.998（2.683～5.960）
3～	1.418	0.245	33.604	<0.001	4.130（2.557～6.671）
5～	1.132	0.243	21.785	<0.001	3.103（1.929～4.992）
7～	0.882	0.234	14.262	<0.001	2.416（1.528～3.818）
15～	0.945	0.241	15.317	<0.001	2.573（1.603～4.130）
≥20	1.721	0.238	52.115	<0.001	5.589（3.503～8.918）
MCV接种剂次数（剂）^b
1	1.112	0.171	42.211	<0.001	3.042（2.175～4.254）
≥2	0.519	0.216	5.781	0.016	1.680（1.101～2.565）
常量	−0.335	0.122	7.536	<0.001	0.715
注：CI. 置信区间；MCV. 含麻疹成分疫苗；a. 以<1岁为参照组；b. 以0剂次为参照组

下载: 导出CSV

表 4 2020－2021年湖南省有含麻疹成分疫苗接种史的健康人群麻疹IgG抗体几何平均浓度多重线性回归分析

Table 4. Multiple linear regression analysis of measles IgG antibody geometric mean concentration of people who got measles-containing vaccine vaccinated in healthy population in Hunan, 2020−2021

变量^a	$s_{\bar x}$	P值	β（95%CI）
末次MCV接种时间间隔	40.080	<0.001	−192.386（−270.986～−113.785）
常量	90.734	<0.001	1180.575（1002.636～1358.514）
注：CI. 置信区间；MCV. 含麻疹成分疫苗；a. MCV接种剂次数为0剂和不详者未纳入分析

下载: 导出CSV

参考文献(21)

[1]	Guerra FM, Bolotin S, Lim G, et al. The basic reproduction number (R₀) of measles: a systematic review[J]. Lancet Infect Dis, 2017, 17(12): E420–428. DOI: 10.1016/S1473−3099(17)30307−9.
[2]	Düx A, Lequime S, Patrono LV, et al. Measles virus and rinderpest virus divergence dated to the sixth century BCE[J]. Science, 2020, 368(6497): 1367–1370. DOI: 10.1126/science.aba9411.
[3]	Wolfson LJ, Strebel PM, Gacic-Dobo M, et al. Has the 2005 measles mortality reduction goal been achieved? A natural history modelling study[J]. Lancet, 2007, 369(9557): 191–200. DOI: 10.1016/S0140−6736(07)60107−X.
[4]	苏琪茹, 徐爱强, Strebel P, 等. 中国消除麻疹的关键技术问题: 专家解读共识[J]. 中国疫苗和免疫,2014,20(3):264–270,283. DOI: 10.19914/j.cjvi.2014.03.015. Su QR, Xu AQ, Strebel P, et al. National and international experts' consensus on key technical issues of measles elimination in China[J]. Chin J Vaccines Immun, 2014, 20(3): 264–270,283. DOI: 10.19914/j.cjvi.2014.03.015.
[5]	Moss WJ. Measles[J]. Lancet, 2017, 390(10111): 2490–2502. DOI: 10.1016/S0140−6736(17)31463−0.
[6]	马超, 郝利新, 温宁, 等. 中国2019年麻疹流行病学特征[J]. 中国疫苗和免疫,2020,26(5):493–497. DOI: 10.19914/j.cjvi.2020.05.002. Ma C, Hao LX, Wen N, et al. Epidemiology of measles in China, 2019[J]. Chin J Vaccines Immun, 2020, 26(5): 493–497. DOI: 10.19914/j.cjvi.2020.05.002.
[7]	中华预防医学会儿童保健分会疾病预防和疫苗接种学组. 重大突发事件对儿童预防接种工作的影响及其应对策略专家建议[J]. 中国实用儿科杂志,2021,36(6):401–407. DOI: 10.19538/j.ek2021060601. Disease Prevention and Vaccination Group of Society of Child Health of China Preventive Medicine Association. Expert suggestions on the influence of major emergencies on preventive vaccination in children and the management strategies[J]. Chin J Pract Pediatr, 2021, 36(6): 401–407. DOI: 10.19538/j.ek2021060601.
[8]	顾卫红, 员朋娟. 新冠肺炎疫情对上海市某社区预防接种工作的影响分析[J]. 健康教育与健康促进,2021,16(1):81–82,106. DOI:10.16117/j.cnki.31−1974/r.202101081. Gu WH, Yuan PJ. The impact of COVID-19 on the vaccination work in one community in Shanghai[J]. Health Educ Health Promot, 2021, 16(1): 81–82,106. DOI: 10.16117/j.cnki.31−1974/r.202101081.
[9]	Bramer CA, Kimmins LM, Swanson R, et al. Decline in child vaccination coverage during the COVID-19 pandemic - Michigan care improvement registry, May 2016-May 2020[J]. MMWR Morb Mortal Wkly Rep, 2020, 69(20): 630–631. DOI: 10.15585/mmwr.mm6920e1.
[10]	Causey K, Fullman N, Sorensen RJD, et al. Estimating global and regional disruptions to routine childhood vaccine coverage during the COVID-19 pandemic in 2020: a modelling study[J]. Lancet, 2021, 398(10299): 522–534. DOI: 10.1016/S0140−6736(21)01337−4.
[11]	骆金俊, 熊伟胜, 李婷婷. 湖北省健康人群麻疹免疫水平监测结果分析[J]. 应用预防医学,2020,26(6):472–475. Luo JJ, Xiong WS, Li TT. Analysis of monitoring results on measles immune level among healthy population in Hubei province[J]. Appl Prev Med, 2020, 26(6): 472–475.
[12]	Papania MJ, Wallace GS, Rota PA, et al. Elimination of endemic measles, rubella, and congenital rubella syndrome from the Western hemisphere: the US experience[J]. JAMA Pediatr, 2014, 168(2): 148–155. DOI: 10.1001/jamapediatrics.2013.4342.
[13]	Nokes DJ, Anderson RM. Measles, mumps, and rubella vaccine: what coverage to block transmission?[J]. Lancet, 1988, 332(8624): 1374. DOI: 10.1016/s0140−6736(88)90920−8.
[14]	段晓健, 赵建楠, 牛丹丹, 等. 中国不同人群麻疹抗体水平分析[J]. 病毒学报,2022,38(2):305–312. DOI: 10.13242/j.cnki.bingduxuebao.004118. Duan XJ, Zhao JN, Niu DD, et al. Analysis of measles antibody level in different populations in China[J]. Chin J Virol, 2022, 38(2): 305–312. DOI: 10.13242/j.cnki.bingduxuebao.004118.
[15]	陈雪婷, 丁亚兴, 雷玥, 等. 2020年天津市0~44岁健康人群麻疹抗体水平和影响因素调查[J]. 中国疫苗和免疫,2022,28(4):390–394. DOI: 10.19914/j.CJVI.2022075. Chen XT, Ding YX, Lei Y, et al. Measles antibody levels and influencing factors in a 0–44 year-old healthy population of Tianjin in 2020[J]. Chin J Vaccines Immun, 2022, 28(4): 390–394. DOI: 10.19914/j.CJVI.2022075.
[16]	胡莹, 陆培善, 邓秀英, 等. 2018-2020年江苏省健康人群麻疹抗体水平监测分析[J]. 疾病监测,2022,37(10):1299–1303. DOI: 10.3784/jbjc.202205260241. Hu Y, Lu PS, Deng XY, et al. Analysis on measles antibody level in healthy population in Jiangsu, 2018–2020[J]. Dis Surveill, 2022, 37(10): 1299–1303. DOI: 10.3784/jbjc.202205260241.
[17]	伍凤云, 何旺瑞, 吴招兰, 等. 2015-2020年江西省健康人群麻疹、风疹抗体水平分析[J]. 现代预防医学,2021,48(7):1160–1164. Wu FY, He WR, Wu ZL, et al. Measles and rubella antibody levels in healthy population of Jiangxi, 2015–2020[J]. Mod Prev Med, 2021, 48(7): 1160–1164.
[18]	李淑华, 王晶晶, 周杰, 等. 上海市1~8月龄小儿麻疹抗体水平消长分析[J]. 上海预防医学,2022,34(6):568–570,576. DOI: 10.19428/j.cnki.sjpm.2022.21567. Li SH, Wang JJ, Zhou J, et al. Establishment of a mathematical model for the analysis of anti-measles antibody reduction trend in children aged 1‒8 months[J]. Shanghai J Prev Med, 2022, 34(6): 568–570,576. DOI: 10.19428/j.cnki.sjpm.2022.21567.
[19]	葛备, 秦才珍, 张以祥, 等. 麻疹疫苗及麻腮风联合疫苗免疫成功率监测分析[J]. 实用预防医学,2010,17(11):2221–2223. DOI:10.3969/j.issn.1006−3110.2010.11.033. Ge B, Qin CZ, Zhang YX, et al. Monitoring on immune successful rate of measles vaccine and measles-mumps-rubella vaccine in Jiangsu[J]. Pract Prev Med, 2010, 17(11): 2221–2223. DOI: 10.3969/j.issn.1006−3110.2010.11.033.
[20]	Seagle EE, Bednarczyk RA, Hill T, et al. Measles, mumps, and rubella antibody patterns of persistence and rate of decline following the second dose of the MMR vaccine[J]. Vaccine, 2018, 36(6): 818–826. DOI: 10.1016/j.vaccine.2017.12.075.
[21]	文海蓉, 廖征, 彭时辉, 等. 南昌市健康人群麻疹疫苗免疫持久性的观察[J]. 职业与健康,2011,27(6):664–665. DOI: 10.13329/j.cnki.zyyjk.2011.06.031. Wen HR, Liao Z, Peng SH, et al. Observation of persistence of measles vaccine among healthy population in Nanchang city[J]. Occup Health, 2011, 27(6): 664–665. DOI: 10.13329/j.cnki.zyyjk.2011.06.031.