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目的了解麻疹风疹的流行病学特征,探讨麻疹与风疹之间的血清学鉴别诊断。方法通过网络直报系统与麻疹日常监测,揭示麻疹发病的流行病学特征;采用酶联免疫吸附法(ELISA)对431例麻疹疑似病例的血清标本进行麻疹IgM和风疹IgM抗体检测。结果431例麻疹风疹疑似病例,疑似麻疹血清检测率为92.43%,疑似风疹血清检测率为100%。麻疹抗体IgM(+)检出率为42%(181/431),风疹抗体IgM(+)检出率为17.63%(76/431),麻疹风疹抗体IgM双(+)检出率为1.86%(8/431)。麻疹发病主要集中在8月龄～2岁,占41.15%(86/209),其次是小于8月龄的婴幼儿占21.05%(44/209)。在出疹后第0～3d、4～7d、8～14d、15～28d前采集的血清标本其麻疹IgM抗体阳性检出率之间经检验有统计学意义(χ2=19.017,P<0.001)。结论本地发热出疹性疾病以麻疹为主;发病年龄分布主要在2岁前,而16岁以后仍然占相当大比例;采血时间与检出率密切相关。
Objective To understand the epidemiological characteristics of measles and rubella and to explore the serological differential diagnosis between measles and rubella. Methods The epidemiological characteristics of measles were revealed through the network direct reporting system and daily monitoring of measles. Serum samples of 431 suspected measles cases were detected by enzyme-linked immunosorbent assay (ELISA) for measles and rubella IgM. Results 431 cases of suspected cases of measles and rubella, measles measles serum detection rate was 92.43%, suspected rubella serum detection rate was 100%. The detection rate of measles antibody IgM (+) was 42% (181/431), the detection rate of rubella antibody IgM (+) was 17.63% (76/431), the detection rate of measles rubella antibody IgM double (+) was 1.86% (8/431). The incidence of measles mainly ranged from 8 months to 2 years, accounting for 41.15% (86/209), followed by 21.05% (44/209) of infants and children less than 8 months old. The detection rate of measles IgM antibody in serum samples collected before 0 ~ 3d, 4 ~ 7d, 8 ~ 14d and 15 ~ 28d after rash was statistically significant (χ2 = 19.017, P <0.001) . Conclusions Local measles-related fever is mainly measles. The age of onset is mainly before the age of 2 years old, but still accounts for a large proportion after the age of 16 years. The blood sampling time is closely related to the detection rate.