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目的了解东莞市自然人群麻疹抗体水平现状,为制定更科学、可行、有效、经济的麻疹防控措施提供科学依据。方法以东莞地区分布为特征分片区,采用多阶段随机抽样方法,按片区随机抽取5个镇(街)15个居委会/行政村,每个居委会/行政村随机抽取0~12月龄每个月龄、1~14岁每个年龄、15岁~、20岁~、25岁~、30岁~、35岁~、40岁~、45岁~等每个年龄段各4人(为保证育龄妇女调查人数,要求≥15岁的各年龄组调查对象男女比例为1:1),共抽取2 043人作为本次监测对象;采集每名对象的静脉血分离血清后应用酶联免疫吸附试验法(ELISA)检测麻疹IgG抗体。结果本省外市户籍人群麻疹抗体水平(GMC 1 092.38 m IU/ml,阳性率81.53%,保护率53.13%)和外省户籍人群麻疹抗体水平(GMC 985.80 m IU/ml,阳性率73.12%,保护率48.29%)均低于本市户籍麻疹抗体水平(GMC 1 106.79 m IU/ml,阳性率85.09%,保护率54.83%),其中阳性率和保护率总体比较差异有统计学意义(χ~2阳性率=35.789,P<0.001;χ~2保护率=6.606,P=0.037);各年龄组间麻疹抗体水平差异有统计学意义(FGMC=26.388,P<0.001;χ~2阳性率=905.853,P<0.001;χ~2保护率=436.861,P<0.001);2~8月龄婴儿麻疹抗体水平(GMC 257.74~613.53 m IU/ml,阳性率10.53%~62.40%,保护率4.39%~23.20%)最低,9~15岁儿童麻疹抗体水平(GMC 879.12~987.97 m IU/ml,阳性率89.57%~94.92%,保护率40.68%~54.78%)也较低,15~35岁育龄妇女麻疹抗体GMC在1 200 m IU/ml左右波动,35岁以上育龄妇女麻疹抗体GMC显著上升,抗体阳性率、抗体保护率变化特征与抗体GMC大致相同。结论 2014年广东省东莞市内外市户籍人群和外省户籍人群、2~8月龄婴儿、9~15岁儿童、35岁以下育龄期妇女为麻疹抗体水平薄弱群体,加强常规免疫、健康宣教、强化免疫、应急接种等免疫干预可有助于实现麻疹低发阶段有效防控。
Objective To understand the status of measles antibody in the natural population in Dongguan City and provide a scientific basis for the development of a more scientific, feasible, effective and economical measles prevention and control measures. Methods The distribution of Dongguan area was divided into three regions. Fifteen neighborhoods / administrative villages were randomly selected from five towns (streets) in the district according to the multi-stage random sampling method. Each neighborhood / administrative village was randomly selected from 0 to 12 months of age Age, every age of 1 to 14 years old, 15 years old, 20 years old, 25 years old, 30 years old, 35 years old, 40 years old, 45 years old and so on each of the four age groups (for guaranteeing women of childbearing age The number of people surveyed, the age group of ≥ 15 years of age required to investigate the proportion of male to female 1: 1), a total of 2,043 were taken as the monitoring object; collected from each subject’s venous blood serum after the application of enzyme-linked immunosorbent assay ELISA) Measles IgG antibody. Results The level of measles antibody (GMC 1 092.38 m IU / ml, positive rate 81.53%, protective rate 53.13%) and measles antibody level (GMC 985.80 m IU / ml) of the registered permanent residents in other provinces were 73.12%, 73.12% 48.29%) were lower than the measles antibody level of Hukou (106.79 mIU / ml GMC 1, the positive rate was 85.09%, the protection rate was 54.83%), the positive rate and the protection rate were statistically significant difference (χ ~ 2positive (FGMC = 26.388, P <0.001; χ ~ 2 positive rate = 905.853, P <0.001; χ ~ 2 protection rate was 6.606, P = 0.037); the antibody level of measles in each age group was significantly different (P <0.001; χ ~ 2 protection rate = 436.861, P <0.001). The measles antibody level of infants aged 2-8 months (GMC 257.74 ~ 613.53 m IU / ml, positive rate 10.53% ~ 62.40%, protection rate 4.39% ~ 23.20 %), The measles antibody level (GMC 879.12 ~ 987.97 m IU / ml, positive rate 89.57% ~ 94.92%, protective rate 40.68% ~ 54.78%) in children aged 9 ~ GMC fluctuated around 1 200 m IU / ml, measles antibody GMC of women of childbearing age above 35 years old increased significantly, and antibody positive rate and antibody protection rate changed roughly the same with antibody GMC. Conclusions In 2014, the registered permanent residents and foreign residents in Dongguan city, Guangdong province, 2 to 8 months old infants, 9 to 15 years old children and women of childbearing age under 35 years old were the measles-weakness group. The routine immunization, health education and strengthening Immunization, emergency vaccination and other immunization interventions can help achieve effective prevention and control of low-level measles.