CAJ | 학술논문

疫苗时代育龄期妇女体内麻疹抗体多为麻疹疫苗所介导，所生婴儿母传抗体消失提前，未及初免月龄已成为易感者。针对北京市及其它一些大城市＜8月龄婴儿麻疹发病越来越突出的情况，为控制该人群发病，选取北京市户籍的6月龄婴儿119人进行麻疹减毒活疫苗（MV）免疫效果及人体反应观察。结果显示：6月龄婴儿中有84％母传抗体已阴转，阳性者抗体水平也极低。接种MV后抗体阳性率达到86.6％，免疫成功率为80.7％，几何平均滴度（GMT）为1∶528.45；接种后的发热率、皮疹率分别为16.8％、2.52％。提示实施6月龄的MV初免程序是可行的。与本市8月龄婴儿初免监测数据相比，6月龄婴儿的MV免疫成功率和GMT偏低，提示婴儿母传抗体的存在对MV的免疫成功率有一定的干扰作用外，与年龄相关的因素如低月龄婴儿免疫系统的发育程度可能是影响免疫效果的更为主要的因素。建议：对6月龄和8月龄婴儿MV初免的成本效果进行研究，如果采取6月龄初免，应考虑在满1岁时复种1剂MV；加快研制免疫原性好并适用于低月龄婴儿的新型MV；对与年龄有关的因素作更深入的探索。
역묘시대육령기부녀체내마진항체다위마진역묘소개도，소생영인모전항체소실제전，미급초면월령이성위역감자。침대북경시급기타일사대성시＜8월령영인마진발병월래월돌출적정황，위공제해인군발병，선취북경시호적적6월령영인119인진행마진감독활역묘（MV）면역효과급인체반응관찰。결과현시：6월령영인중유84％모전항체이음전，양성자항체수평야겁저。접충MV후항체양성솔체도86.6％，면역성공솔위80.7％，궤하평균적도（GMT）위1∶528.45；접충후적발열솔、피진솔분별위16.8％、2.52％。제시실시6월령적MV초면정서시가행적。여본시8월령영인초면감측수거상비，6월령영인적MV면역성공솔화GMT편저，제시영인모전항체적존재대MV적면역성공솔유일정적간우작용외，여년령상관적인소여저월령영인면역계통적발육정도가능시영향면역효과적경위주요적인소。건의：대6월령화8월령영인MV초면적성본효과진행연구，여과채취6월령초면，응고필재만1세시복충1제MV；가쾌연제면역원성호병괄용우저월령영인적신형MV；대여년령유관적인소작경심입적탐색。
In vaccine era, measles antibody in women of childbearing age is vaccine-induced, and the maternal antibody of their infants disappeared in advance. In big city, such as Beijing, more and more <8 month-old infants who do not reach the first immunization age are attacked by measles virus. We selected 119*"6 month-old infants, giving them measles vaccine (MV) , to observe their immune response and clinical reaction. The results showed the maternal antibody in 84% of the 6 month-old infants before vaccination were negative, and the antibody level in rest of them were very low. After MV vaccination, their seropositive rate reached 86.6%, the immunization successful rate was 80.7%, the GMT was 1∶528.45, the rates for fever and rash were 16.8% and 2.52% respectively, suggesting that the first vaccination of MV in 6 month-old infants is feasible. Compared with infants primarily vaccinated at 8 months old, both the immunization successful rate and GMT were lower. This means that there is interference of residual maternal antibody with vaccine but most chiefly contributes to the immature development of the immune system of the infants (age related factor). We recommend to give the first dose of MV to infants of 6 months old and the second dose at 1 year old, but before doing this, it is necessary to do cost effectiveness analysis and to explore new MV with good antigenicity to infants of lower age.