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2012–2014年江苏省儿童肠道病毒71型血清流行病学特征分析
作者:周洋 李靖欣 孟繁岳 胡月梅 金鹏飞 张雪峰 朱凤才

摘要:

目的  分析2012–2014年江苏省6~35月龄儿童肠道病毒71型(EV-A71)中和抗体变化规律及在不同人群中的分布特征。方法  2012年3月至2014年3月,以江苏省赣榆县、射阳县、东海县、宝应县、邳州市和泰兴市为研究现场,依托现场建立的肠道病毒监测系统,结合监护人主动报告和被动就医的方式,对该期间入组的1 276名6~35月龄安慰剂组研究对象进行基线时、随访第1年和第2年定期血清学随访,对发现疑似肠道病毒感染所致疾病患者,采集标本进行EV-A71病原学确诊。采用χ2检验、χ2趋势检验或方差分析分别比较不同特征调查对象EV-A71中和抗体阳性率和抗体几何平均滴度(GMT)水平的差异。结果  2年随访中,EV-A71中和抗体阳性率随着年龄增加而升高(χ2趋势值分别为39.33、56.41和32.25,P值均<0.001),基线时、随访第1年和第2年分别为22.57%(288/1 276)、37.72%(444/1 177)和42.84%(422/985);基线时、随访第1年和第2年GMT水平分别为9.95、15.37和24.05(F值分别为22.90、46.36和41.58,P值均<0.001)。2年间,EV-A71年新发感染率分别为13.47%(158/1 173)和20.73%(192/926),其中,319例基线时月龄为24~35的儿童2年间新发感染率较高,基线时至随访第1年为17.87%(57例),随访第1年至第2年为27.20%(65例);EV-A71中和抗体年衰减率分别为2.81%(33/1 173)和8.10%(75/926)。结论  2012–2014年,江苏省儿童EV-A71中和抗体阳性率和GMT水平随着年龄增长而上升;3~4岁儿童EV-A71新发感染率较高;自然感染后所诱导的EV-A71中和抗体水平可至少维持2年。

关键词:肠道病毒属;中和,抗体;血清流行病学;队列研究

Abstract:

Objective  To analyze the dynamic pattern and the distributive characteristics of neutralizing antibody against enterovirus 71 (EV-A71 ) in children aged 6-35 months in Jiangsu province from 2012 to 2014.Methods  From March, 2012 to March, 2014, a total of 1 276 children aged between 6 and 35 months were regularly followed up on day 0, year 1 and year 2 for EV-A71 neutralizing antibody test based on the enterovirus surveillance system, with the method of reporting by their guardian or being visited in Ganyu Sheyang Taixing Donghai Pizhou and Baoying in Jiangsu province. At the same time, samples were taken from the suspected persons infected by enterovirus. The χ2 test or variance analysis was used to compare the difference of the positive rates and the geometric mean titer(GMT) of EV-A71 neutralizing antibody in different subjects.Results  In 2 years follow-up, the positive rates of EV-A71 antibody increased as the growth of the age,and the positive rates on day 0, year 1 and year 2 were 22.57% (288/1 276), 37.72%(444/1 177) and 42.84%(422/985), respectively (χ2 values were 39.33, 56.41, 32.25; P< 0.001).The GMTs were 9.95, 15.37 and 24.05, respectively (F values were 22.90,46.36,41.58;P<0.001). In 2 years, the annually new infection rates were 13.47%(158/1 173) and 20.73%(192/926),respectively, and the annually decay rates of EV-A71 antibody were 2.81%(33/1 173) and 8.10%(75/926).Conclusions  In 2012 to 2014, the positive rates and the GMTs of EV-A71 antibody of children increased as the growth of the age in Jiangsu. The higher annually new infection rate was in children aged 3 to 4 years. The EV-A71 neutralizing antibody level could maintain at least two years after natural infection.

Key words: Enterovirus;Antibodies, neutralizing;Seroepidemiology;Cohort study

发表日期:2015/12

引用本文:

图/表:

  • 10.3760/cma.j.issn.0253-9624.2015.12.006.T001:表1 江苏省不同月龄、性别和地区儿童基线及随访时肠道病毒71型中和抗体阳性情况比较

    10.3760/cma.j.issn.0253-9624.2015.12.006.T001:表1 江苏省不同月龄、性别和地区儿童基线及随访时肠道病毒71型中和抗体阳性情况比较

  • 10.3760/cma.j.issn.0253-9624.2015.12.006.T002:表2 江苏省不同月龄、性别和地区儿童基线及随访时肠道病毒71型中和抗体GMT水平

    10.3760/cma.j.issn.0253-9624.2015.12.006.T002:表2 江苏省不同月龄、性别和地区儿童基线及随访时肠道病毒71型中和抗体GMT水平

  • 10.3760/cma.j.issn.0253-9624.2015.12.006.T003:表3 江苏省不同月龄、性别和地区儿童随访时肠道病毒71型新发感染情况

    10.3760/cma.j.issn.0253-9624.2015.12.006.T003:表3 江苏省不同月龄、性别和地区儿童随访时肠道病毒71型新发感染情况

  • 10.3760/cma.j.issn.0253-9624.2015.12.006.T004:表4 江苏省不同月龄、性别和地区儿童随访时肠道病毒71型中和抗体衰减情况

    10.3760/cma.j.issn.0253-9624.2015.12.006.T004:表4 江苏省不同月龄、性别和地区儿童随访时肠道病毒71型中和抗体衰减情况

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