育龄妇女接种麻疹疫苗对婴儿麻疹抗体及麻疹疫苗接种的影响

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摘要目的：研究育龄妇女接种麻疹疫苗后所生婴儿的胎传麻疹抗体的动态变化，并了解其对婴儿接种麻疹疫苗的影响。方法：选择2012年1月1日至2012年12月31日300位育龄妇女纳入本研究，检测麻疹IgG抗体后进行随机对照试验（RCT），设立高抗体无疫苗接种组（I组，52例）、高抗体疫苗接种组（II组，53例）、低抗体无疫苗接种组（III组，98例）和低抗体疫苗接种组（IV组，97例）。I组和III组不接种疫苗，II组和IV组接种麻腮风联合减毒活疫苗，各组均于待产时检测麻疹IgG抗体。检测育龄妇女所生婴儿出生时、8月龄大时、接种麻疹疫苗后半个月和接种麻疹疫苗后3个月血麻疹IgG抗体，于接种麻疹疫苗后半个月同时检测麻疹IgM抗体。分析育龄妇女待产时麻疹IgG抗体水平与婴儿出生时IgG抗体水平的相关性，分析婴儿麻疹IgG抗体的动态变化及IgM抗体的情况。结果：对育龄妇女待产时麻疹IgG抗体水平与新生儿脐带血麻疹IgG抗体水平进行pearson相关分析，显示相关系数为0.85，P=0.00，提示存在相关性。重复测量方法分析结果显示，I组和II组、III组和IV组之间婴儿麻疹IgG抗体变化差均异有统计学意义（均P=0.00），而I组和III组、II组和IV组之间差异无统计学意义（分别为P=0.11和P=0.45）。接种后3个月各组间比较，F=1.36，P= 0.26，提示各组间此时间点上差异无统计学意义。婴儿IgG抗体趋势图显示，婴儿的胎传麻疹抗体水平随时间逐步减少，在接种麻疹疫苗3个月时又明显升高。I～IV组婴儿麻疹IgM抗体样本/临床值比值（S/CO值）经单因素方差分析，F=0.95，P=0.42，提示各组间差异无统计学意义。结论：育龄妇女接种麻疹疫苗可提高所生婴儿胎传麻疹抗体水平，使婴儿在接种麻疹疫苗前获得足够的保护性抗体，也不会影响婴儿接种麻疹疫苗的效果。

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关键词 ：麻疹, 育龄妇女, 胎传抗体, 疫苗

Abstract：Objective: To study the dynamic changes of the measles antibody in infants born to women who were vaccinated against measles, and to understand the effect of measles vaccination on the infants. Methods: This study was performed from January 01, 2012 to December 31, 2012 on 300 women of childbearing age. The infants born to these women were divided into the following 4 groups in a randomized and controlled trial (RCT) for measles IgG antibody detection: High antibody non-vaccination group (Group I, 52 cases), High antibody vaccination group (Group II, 53 cases), Low antibody non-vaccination group (Group III, 98 cases), and Low antibody vaccination group (Group IV, 97 cases). Group I and Group III were not vaccinated, while Group II and Group IV were vaccinated with the measles-mumps-rubella vaccine. In all cases, the expectant mothers had the IgG antibodies. All the infants showed IgG antibodies at birth and at the age of 8-and-half months and at 3 months after vaccination. Moreover, measles IgM antibody was detected within half a month after vaccination. A correlation analysis of the level of measles IgG antibody in the infants at birth and the expecting women of childbearing age was performed to study the dynamic changes in the IgG antibody and the IgM antibody levels in infants. Results: There was a significant correlation between the antibody level of the expectant women of childbearing age and the infants at birth (r=0.85). The results of repeated measures analysis showed that there were significant differences in the changes of IgG levels between Group I and III and Group II and IV (all P=0.00), while there was no significant difference between Group I and III and Group II and IV (P=0.11 and P=0.45). At 3 months after inoculation, the groups were compared and F=1.36 and P=0.26, which indicated that there was no significant difference in the time between the groups. The trend chart of IgG antibody showed that the level of infants’ measles fetal transmission antibody decreased gradually with time, and increased at 3 months after vaccination. The ratio of the IgM sample/clinical value of infant measles (S/CO value) of all the groups was analyzed by single factor analysis of variance, and no significant difference was found between each group (F=0.95, P=0.42). Conclusion: The findings of this study show that infants of women of childbearing age who undergo measles vaccination have sufficient protective antibodies before their vaccination, and these antibodies do not affect their measles vaccination.

Key words： measles women of childbearing age fetal transmission antibody vaccine

收稿日期: 2016-02-02

基金资助:温州市科技计划项目（Y20130364）；国家卫计委国家重点临床专科开放课题（20130102）。

通讯作者: 林海龙，副主任医师，Email：330635754@qq.com。

作者简介: 夏蝉（1980-），女，浙江温州人，主治医师，硕士。

链接本文:

https://xb.wmu.edu.cn/CN/ 或 https://xb.wmu.edu.cn/CN/Y2016/V46/I11/813

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