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近年来 ,西安市未及接种麻疹疫苗 (MV)的周岁内婴儿麻疹发病有增高趋势 ,为查明原因 ,在 2 0 0 0年春季对西安市儿童医院收治的 436例≤ 7岁麻疹患儿进行了分析。结果 <8月龄未接种MV的病例占 34 40 % ,发病最多的是 6、7、8月龄 ,分别占周岁内病例数的 18 18%、15 91%和 2 1 82 %。同时随机抽取 5 1名 5～ 8月龄未接种MV未患过麻疹的健康婴儿和 6 3名育龄期妇女 ,用酶联免疫吸附试验 (ELISA)间接法检测麻疹IgG抗体 ,结果 7名 5月龄儿童麻疹抗体阳性率为 5 7 14% ,GMT为 1∶148 4,随月龄增长抗体阳性率逐渐下降 ,12名 8月龄婴儿均为阴性。 6 3名育龄期妇女抗体阴性占 15 87% ,抗体处于低水平占 5 8 73% ,中等水平 19 0 5 % ,高水平只占 6 35 %。此结果表明 ,婴儿发生麻疹主要是母亲麻疹抗体水平低 ,导致婴儿母传抗体水平低、维持时间短 ,不能保护婴儿至 8月龄MV初种时。因此建议对育龄期妇女进行婚前MV接种 ,并将MV初种月龄调整至 6月龄。
In recent years, the incidence of measles in infants less than the age of vaccination against measles in Xi’an has been increasing. To find out the reasons, 436 infants with measles age ≤7 years admitted to Children’s Hospital of Xi’an in the spring of 2000 Analyzed. Results 34% of unvaccinated MV patients aged <8 months accounted for 34-40% of the total number of cases. The most frequent cases were 6, 7 and 8 months old, accounting for 18 18%, 15 91% and 21 82% of cases. At the same time, 51 healthy infants and 6 3 women of child-bearing age who were not vaccinated with MV from 5 to 8 months old were randomly selected and measles IgG antibodies were detected by indirect ELISA (ELISA). Results Seven The positive rate of measles antibody was 57.14% and the GMT was 1:148 4. The positive rate of antibody decreased gradually with the increase of age. All 12-month-old babies were negative. Six of the three women of childbearing age were negative, accounting for 15-87% of the total. Antibodies accounted for 58.73% of the low level, 19.5% of the medium level, and 635% of the high level. This result indicates that measles in infants is mainly due to low levels of maternal measles antibody, low maternal antibody levels in infancy and short maintenance periods, which can not protect infants to 8 months of age at the beginning of MV. Therefore, it is recommended that women of childbearing age be vaccinated with prenuptial MVs, and adjust the initial month of MV to 6 months of age.