2014－2018年云南省健康人群钩端螺旋体抗体水平监测结果分析

杨秋菊; 杨向东; 杨慧; 夏淑婷; 于彬彬

doi:10.3784/jbjc.202206150269

2014－2018年云南省健康人群钩端螺旋体抗体水平监测结果分析

Surveillance results for Leptospira antibody level in healthy population in Yunnan, 2014−2018

摘要

摘要:
目的了解云南省钩端螺旋体（钩体）病自然疫源地健康人群抗体水平及菌群分布，并分析其流行规律，为预防和控制钩体病提供科学依据。
方法在云南省华坪县、孟连县和勐腊县3个钩体病国家级监测点采集健康人群血清，运用暗视野显微镜凝集实验进行15群15型钩体抗体检测。
结果 2014—2018年云南省钩体病监测点每年采集健康人血清300份，5年监测的钩体血清抗体阳性率分别为29.67%、28.33%、15.67%、10.33%、14.33%，总阳性率为19.67%，5年的钩体血清抗体阳性率差异有统计学意义（χ²=58.232，P<0.05）。 5年各监测点阳性率分别是华坪县15.40%、孟连县19.60%和勐腊县24.00%，勐腊县阳性率比5年总阳性率高，华坪县和孟连县阳性率比5年总阳性率低，3个地区钩体血清抗体阳性率差异有统计学意义（χ²=11.705，P<0.05）。钩体血清抗体各年龄段阳性率之间差异无统计学意义（χ²=7.131，P>0.05）。检测出的295份阳性血清中15个血清群均有感染，其中以黄疸出血群为主，占35.05%，其次为致热群和澳洲群，分别占14.69%和12.37%。
结论云南省3个国家级监测点健康人群血清钩体抗体阳性率在2014 — 2017年间呈下降趋势，2018年略有所上升；人群所感染的菌群、菌型比较复杂，常见的15个血清群均有分布，以黄疸出血群为主要感染血清群。

Abstract:
Objective To understand the antibody level and infected serogroup distribution of Leptospira in healthy population in the natural foci of leptospirosis in Yunnan province, analyze the local incidence trend of leptospirosis and provide scientific basis for the prevention and control of leptospirosis in Yunnan.
Methods The serum samples of healthy people collected from three national surveillance sites of leptospirosis in Huaping, Menglian and Mengla counties of Yunnan were used for dark field microscope agglutination test with a panel of 15 pathogenic Leptospira live antigens representing 15 different serogroups.
Results A total of 300 serum samples of healthy people were collected from three leptospirosis monitoring sites from 2014 to 2018 in Yunnan. The serum positive rate of Leptospira antibody in the five years were 29.67%, 28.33%, 15.67%, 10.33% and 14.33% respectively, and the overall serum positive rate of Leptospira antibody was 19.67%. The difference in serum positive rate of Leptospira antibody among the five years were significant (χ²=58.232, P<0.05). The positive rates in Huaping, Menglian and Mengla counties were 15.40%, 19.60% and 24.00% respectively. The serum positive rate of Leptospira antibody in Mengla was higher than the overall serum positive rate of the five years, and the positive rates in Huaping and Menglian were lower than the overall serum positive rate of the five years. The differences in the serum positive rate of Leptospira antibody among the three areas were significant (χ²=11.705, P<0.05). There were no significant differences in the serum positive rate of Leptospira antibody among the different age groups (χ²=7.131, P>0.05). Among the 295 positive serum samples detected, 15 serogroups of Leptospira were detected, in which the Icterohaemorrhagiae was predominant serogroup, accounting for 35.05%, followed by Pyrogenes and Australis, accounting for 14.69% and 12.37% respectively.
Conclusion The serum positive rate of Leptospira antibody in healthy population in three national surveillance sites in Yunnan showed a downward trend from 2014 to 2017, but slightly increased in 2018. The species and types of Leptospira infecting people were complex, and 15 serogroups were detected, with Icterohaemorrhagiae as the main serogroup.

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