CAJ | 학술논문

目的考察灭活脊髓灰质炎疫苗(inactivated poliomyelitis vaccine,IPV)在中国婴儿中的免疫效果,并与目前常规使用的口服脊髓灰质炎减毒活疫苗(oral poliomyelitis vaccine,OPV)进行比较.方法对2个月龄婴儿采用组群随机法分为2个组,每组208名,分别接种IPV和OPV,并采集免疫前后血清.采用微量中和方法,对血清中抗脊髓灰质炎病毒3个型的中和抗体进行测定,对于抗体保护率比较采用X2检验进行统计学处理.抗体滴度进行对数转换后采用Z检验进行比较,所有统计学检验以P<0.05来确定差异是否具有统计学意义.结果婴儿经初次免疫后,IPV组Ⅰ、Ⅱ、Ⅲ型病毒中和抗体保护率分别为100.0%(186/186)、97.3%(181/186)、98.9%(184/186),几何平均滴度(GMT)分别为151.2、86.7、211.3,OPV组Ⅰ、Ⅱ、Ⅲ型病毒中和抗体保护率分别为97.4%(188/193)、100.0%(193/193)、95.3%(184/193),GMT分别为1089.5、538.2、203.7.两组中Ⅰ、Ⅱ型的保护率差异没有统计学意义(Ⅰ、Ⅱ型分别为X2Ⅰ=2.991,P=0.084;X2Ⅱ=3.512,P=0.061),但Ⅲ型中差异有统计学意义(X2Ⅱ=4.143,P=0.042).IPV组Ⅰ、Ⅱ型抗体几何平均滴度低于OPV疫苗,差异有统计学意义(ZⅠ=12.537,P=0.000;ZⅡ=13.415,P=0.000),而Ⅲ型抗体几何平均滴度差异没有统计学意义(ZⅢ=0.067,P=0.947).结论经基础免疫后IPV在婴儿中免疫效果良好,和OPV相比,IPV组Ⅰ、Ⅱ型保护率与OPV相当,Ⅲ型高于OPV组.IPV组Ⅰ、Ⅱ型抗体几何平均滴度低于OPV疫苗,而Ⅲ型抗体几何平均滴度与OPV组相当.
목적 고찰멸활척수회질염역묘(inactivated poliomyelitis vaccine,IPV)재중국영인중적면역효과,병여목전상규사용적구복척수회질염감독활역묘(oral poliomyelitis vaccine,OPV)진행비교.방법 대2개월령영인채용조군수궤법분위2개조,매조208명,분별접충IPV화OPV,병채집면역전후혈청.채용미량중화방법,대혈청중항척수회질염병독3개형적중화항체진행측정,대우항체보호솔비교채용X2검험진행통계학처리.항체적도진행대수전환후채용Z검험진행비교,소유통계학검험이P<0.05래학정차이시부구유통계학의의.결과영인경초차면역후,IPV조Ⅰ、Ⅱ、Ⅲ형병독중화항체보호솔분별위100.0%(186/186)、97.3%(181/186)、98.9%(184/186),궤하평균적도(GMT)분별위151.2、86.7、211.3,OPV조Ⅰ、Ⅱ、Ⅲ형병독중화항체보호솔분별위97.4%(188/193)、100.0%(193/193)、95.3%(184/193),GMT분별위1089.5、538.2、203.7.량조중Ⅰ、Ⅱ형적보호솔차이몰유통계학의의(Ⅰ、Ⅱ형분별위X2Ⅰ=2.991,P=0.084;X2Ⅱ=3.512,P=0.061),단Ⅲ형중차이유통계학의의(X2Ⅱ=4.143,P=0.042).IPV조Ⅰ、Ⅱ형항체궤하평균적도저우OPV역묘,차이유통계학의의(ZⅠ=12.537,P=0.000;ZⅡ=13.415,P=0.000),이Ⅲ형항체궤하평균적도차이몰유통계학의의(ZⅢ=0.067,P=0.947).결론 경기출면역후IPV재영인중면역효과량호,화OPV상비,IPV조Ⅰ、Ⅱ형보호솔여OPV상당,Ⅲ형고우OPV조.IPV조Ⅰ、Ⅱ형항체궤하평균적도저우OPV역묘,이Ⅲ형항체궤하평균적도여OPV조상당.
Objective To study the immunological effectiveness of inactivated poliomyelitis vaccine (IPV) for children's primary vaccination in China and to compare with the oral poliomyelitis vaccine (OPV) used in routine vaccination. Methods The 2-mouth-old children were ran domly immunized with IPV and OPV,with 208 subjects in each group. The pre-and post-vaccination blood samples were collected. Micro-neutralization method was used to measure the antibody response against 3 types of polioviruses. X2 test was used to evaluate the statistical difference of protection rates between two groups, while the antibody titers were transformed by logarithm and analyzed by Z-test. P <0.05 was always used to define the significance of analysis. Results After 3 doses of immunization, the protection rates in IPV group reached to 100.0% (186/186) ,97.3% (181/186), 98.9% (184/186) for poliovirus type 1,2,3, respectively, and in OPV group were 97.4% (188/193), 100. 0% ( 193/193 ) ,95. 3% ( 184/193 ), respectively. The geometry mean titers(GMTs) were 151.2,86.7,211.3 for IPV group; and 1089.5,538.2,203.7 for OPV group. IPV showed comparable protection rates with OPV for type 1 and 2 (X2Ⅰ=2.991, P=0.084;X2Ⅱ= 3.512,P= 0.061) ,while type 3 was higher than OPV(X2Ⅲ=4.143 ,P=0.042). The GMT of type 1 and 2 in IPV group were lower than OPV group(ZⅠ=12.537, P = 0.000 ; ZⅡ=13.415, P=0.000 ), while the GMT of type 3 were comparable in two groups (ZⅢ=0.067, P=0.947). Conclusion IPV showed roughly comparable immunological effectiveness in young children. The protection rates for type 1 and 2 were similar to OPV, while type 3 was higher than in OPV group; In terms of GMT, type 1 and 2 in IPV group were lower than OPV,but type 3 were comparable to OPV group.