摘要
目的 调查河北省2023年344名健康人群百日咳抗体水平,了解人群百日咳感染情况,估计人群百日咳潜在感染情况。方法 采用分层随机抽样法选取2023年河北省7个地市(县)全年龄段健康人群共344名,收集调查对象的人口学特征、含百日咳成分疫苗接种史、百日咳患病史;采集调查对象的血液样本,应用酶联免疫吸附法(enzymelinked immunosorbent assay, ELISA)检测血清百日咳毒素IgG抗体(pertussis toxin IgG, PT-IgG)水平。结果 344名健康人群PT-IgG几何平均浓度(geometric mean concentration, GMC)为5.28 IU/mL,PT-IgG浓度≥40 IU/mL占6.10%(21/344);男女性抗体水平和抗体浓度≥40 IU/mL占比差异均无统计学意义;抗体浓度≥40 IU/mL前3的地区分别为邢台新河县(20.00%)、保定市莲池区(11.43%)、石家庄市(9.37%),不同地区间百日咳PT-IgG抗体水平有差异,且差异有统计学意义(P=0.007),不同地区百日咳PT-IgG浓度≥40 IU/mL占比差异无统计学意义(P=0.100);1~<3岁年龄组PT-IgG抗体GMC最高(11.45 IU/mL),其次为<1岁年龄组(8.15 IU/mL),不同年龄组间百日咳PT-IgG抗体水平有差异,且差异有统计学意义(P=0.001),1~<3岁年龄组抗体浓度≥40 IU/mL占比最高(20.83%),其次为<1岁年龄组(12.77%),不同年龄组间百日咳PT-IgG抗体浓度≥40 IU/mL占比有差异,且差异有统计学意义(P=0.028)。344名健康人群中,303(88.08%)人有白喉、破伤风和无细胞型百日咳(diphtheria,tetanus,and acellular pertussis, DTaP)免疫接种史,其中完成1~2剂次、3剂次、4剂次分别占4.62%、46.86%、48.52%,完成1~2剂次DTaP疫苗接种史的健康人群中,不同年龄组间百日咳PT-IgG抗体水平差异无统计学意义(P=0.47),完成3剂次基础免疫和4剂次完整免疫的健康人群中,各年龄组间百日咳PT-IgG抗体水平有差异,且差异均有统计学意义(P=0.04,P=0.01),不同年龄组不同免疫剂次间百日咳PT-IgG抗体浓度≥40 IU/mL占比差异无统计学意义(P=0.72)。结论 河北省2023年健康人群百日咳PT-IgG抗体浓度和PTIgG抗体浓度≥40 IU/mL占比均处于低水平,提示我省儿童现行的免疫接种计划产生的保护效果存在不足,可能存在接受疫苗免疫的人群仍然感染百日咳的现象,需进一步加强监测,优化免疫策略。
Objective To investigate the level of pertussis antibody in 344 healthy population in Hebei Province in 2023,and to understand the infection status and estimate the potential infection of pertussis.Methods A total of 344 healthy people of all ages from 7 cities(counties)in Hebei Province in 2023 were stratified by random sampling method.The demographic characteristics,vaccination history and pertussis history of the subjects were collected.Serum IgG antibody against pertussis toxin(PT-IgG)were determined by enzyme-linked immunosorbent assay(ELISA).Results The geometric mean concentration(GMC)of PT-IgG in 344 healthy people was 5.28 IU/mL,and the antibody positive rate(PT-IgG concentration≥40 IU/mL)was 6.10%(21/344).There was no significant difference in proportion of antibody levels and antibody concentration≥40 IU/mL between males and females.The top three regions with the highest antibody positive rate were Xinhe County in Xingtai(20.00%),Lianchi District in Baoding(11.43%),and Shijiazhuang(9.37%).There was a significant difference in pertussis antibody levels among different regions(P=0.007),but no significant difference in pertussis antibody concentration≥40 IU/mL among different regions(P=0.100).The GMC of antibody was the highest in the 1~<3 years old group(11.45 IU/mL),followed by the<1 year old group(8.15 IU/mL).There was a significant difference in the pertussis antibody levels among different age groups(P=0.001).The proportion of antibody concentration≥40 IU/mL was the highest in the 1~<3 years old group(20.83%),followed by the<1 year old group(12.77%).There was a significant difference in the proportion of antibody concentration≥40 IU/mL among different age groups(P=0.028).And 303(88.08%)cases of the 344 healthy people had a history of DTaP,4.62%,46.86%and 48.52%of healthy people had completed 1-2,3 and 4 doses of DTaP,respectively.Among the healthy people who had completed 1-2 doses of DTaP,there was no significant difference in the level of pertussis antibody among different age groups(P=0.47).Among the healthy people who had completed 3 doses of basic immunization and 4 doses of complete immunization,there was a significant difference in the level of pertussis antibody among different age groups(P=0.04,P=0.01).There was no significant difference in the proportion of PT-IgG concentration≥40 IU/mL among different age groups and different immunization doses(P=0.72).Conclusion The overall antibody level and proportion of PT-IgG concentration≥40 IU/mL in the healthy population of Hebei Province in 2023 were both low,indicating the inadequacy of the protective effect of the current immunization program for children,although vaccinated people could still infect with pertussis disease,we need to further monitoring and optimization of immune strategies indicating.
作者
王乐雨
何宝花
曹玉雯
贾肇一
王伟
王茜
孙印旗
WANG Leyu;HE Baohua;CAO Yuwen;JIA Zhaoyi;WANG Wei;WANG Qian;SUN Yinqi(Hebei Provincial Key Laboratory of Pathogens and Epidemiology of Infection Diseases,Hebei Provincial Center for Disease Control and Prevention,Shijiazhuang,Hebei 050021,China)
出处
《中国热带医学》
北大核心
2025年第2期171-175,共5页
China Tropical Medicine
基金
河北省卫生健康委科研基金项目(No.20210177)。
关键词
百日咳
抗体
健康人群
Pertussis
antibody
healthy people
作者简介
王乐雨(1990-),女,硕士,主治医师,研究方向:细菌性传染病防控。;通信作者:孙印旗,E-mail:hbsunyq@163.com。
