CAJ | 학술논문

目的研究成人麻疹暴发流行和临床特点及发生原因. 方法对患者逐一作流行病学等调查分析、血清抗－麻疹病毒(MV)lgM等检测. 结果流行持续33 d,发病149例,均男性.年龄19～23(21.4)岁.发病率占学员总数的4.3%,其中1个队45.5%(51/112)发病.149例来自全国23个省、市、自治区,64.4%来自农村,88.5%为1996/1998从家直接入学,3例有麻疹病史,2例可疑有麻疹病史.有、无麻疹疫苗接种史及接种史不详者分别为2(1.4%)、19(12.8%)和123(82.6%)例. 有典型、不典型皮疹及无皮疹者分别为57(38.3%),44(29.6%)和48(32.2%)例,其急性期血清抗－MV lgM阳性分别为31(54.4%),21(47.7%)和18(37.5%)例,后两者恢复期抗-MV IgM 91.9%阳性,抗－风疹病毒IgM均阴性. 抽检有麻疹病史及无皮疹的27例患者急性期血清抗-MV IgG 阳性分别为1∶200 2例（7. 4%），1∶400的 18例（66. 7%）和1∶800的 7例（25. 9%）. 结论我国农村和中小城市中存在数目较大的易感麻疹的青年人口，其中61. 7%的患者可能为抗-MVIgG衰减所致其症状不典型而极易误诊；他们亦应是预防接种的重要对象.
목적연구성인마진폭발류행화림상특점급발생원인. 방법대환자축일작류행병학등조사분석、혈청항－마진병독(MV)lgM등검측. 결과류행지속33 d,발병149례,균남성.년령19～23(21.4)세.발병솔점학원총수적4.3%,기중1개대45.5%(51/112)발병.149례래자전국23개성、시、자치구,64.4%래자농촌,88.5%위1996/1998종가직접입학,3례유마진병사,2례가의유마진병사.유、무마진역묘접충사급접충사불상자분별위2(1.4%)、19(12.8%)화123(82.6%)례. 유전형、불전형피진급무피진자분별위57(38.3%),44(29.6%)화48(32.2%)례,기급성기혈청항－MV lgM양성분별위31(54.4%),21(47.7%)화18(37.5%)례,후량자회복기항-MV IgM 91.9%양성,항－풍진병독IgM균음성. 추검유마진병사급무피진적27례환자급성기혈청항-MV IgG 양성분별위1∶200 2례（7. 4%），1∶400적 18례（66. 7%）화1∶800적 7례（25. 9%）. 결론아국농촌화중소성시중존재수목교대적역감마진적청년인구，기중61. 7%적환자가능위항-MVIgG쇠감소치기증상불전형이겁역오진；타문역응시예방접충적중요대상.
AIM　To study the causes,epidemiological and clinical features of measles outbreak in adults.METHODS　Every patient with measles was investigated for epidemiology,and anti－measles virus (MV)lgM was tested in sera byusing an EIA.RESULTS　 The epidemic duration of the measles outbreak was 33 days．149 male students were sickness with measles,and their mean age was 21.4 (19 to23) years old．The morbidity was 4.3% of all students,and was 45.5% (51/112) of the students in one team where the morbidity was the highest．149 patients came from 24 provinces,of them 64.4% came from countryside and 88.5% admitted to the college directly from their homes from 1996 to 1998.There were measles history in 3 cases and suspected measles history in 2 cases.Patients with, without and uncertain measles vaccine history were 2(1.4%),19(12.8%) and 123(82.6%) cases, respectively．Patients with typical, atypical and without skin rash were 57(38.3%),44(29.6%) and 48(32.2%)cases,and the positivve rates of anti－MV IgM in their sera in acute phase were 54.4%(31 cases),47.7%(21) and 37.5%(18), respectively;and the positive rate of anti-MV lgM was 91.9% in recovered phase in both latter. The positive rates of anti-MV IgG 1∶200,1∶400 and 1∶800 in sera in acute phase were 7.4%( 2 cases),66. 7%(18)and 25.9%(7), respectively,in 27 tested patients with measles history and without skin rash. Anti-rubella IgM in the sera was negative in all patients．CONCLUSION　There are a large number of young adults susceptible to measles in countryside and some cities in our nation,of them 61.7% with atypical symptoms (easy to misdiagnosis) may be due to decreased anti-MV IgG;they should be planned for vaccine．