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目的分析狂犬病疫苗接种后的免疫效果,为科学防治狂犬病提供指导。方法采用间接ELISA法对隆林县2010-2012年期间1 646例狂犬病疫苗接种后血清抗体进行检测。结果隆林县2010-2012年1 646例狂犬病疫苗接种后抗体阳性率为94.53%。10岁以下暴露者人数最多,最小6个月,最大84岁,抗体阳性率随年龄增长呈明显下降趋势,其差异有统计学意义(χ2=44.00,P<0.05)。不同免疫程序抗体阳性率:全程免疫92.41%、全程免疫联合人抗狂犬病毒免疫球蛋白(HRIG)99.36%、加强免疫96.86%,差异有统计学意义(χ2=21.03,P<0.05)。未考虑饮食禁忌的阴性患者比例最大32.22%(29/90),男性最为明显;提前或推迟接种时间甚至漏针的阴性患者23.33%(21/90);女性受体质或用药影响的比例最多占31.25%(10/32)。季节、性别因素对免疫效果的影响差异无统计学意义(P>0.05)。结论及时、全程、足量接种狂犬病疫苗可有效保护健康。重伤患者注射HRIG后,再全程免疫效果显著。饮食、伤口的处理、体质或使用免疫抑制剂影响免疫效果。
Objective To analyze the immune effect after rabies vaccination and provide guidance for the scientific prevention and treatment of rabies. Methods The indirect ELISA method was used to detect the serum antibody of 1 646 rabies vaccination in Longlin County from 2010 to 2012. Results The positive rate of antibody in 1664 rabies vaccines from 2010 to 2012 in Longlin County was 94.53%. The number of exposed persons under the age of 10 was the largest, with a minimum of 6 months and a maximum of 84 years. The positive rate of antibodies decreased with age, with a significant difference (χ2 = 44.00, P <0.05). The positive rates of antibodies in different immunization programs were 92.41% of the whole immunization, 99.36% of the rabies virus immunoglobulin (HRIG) and 96.86% of the booster immunization in the whole course of immunization. The difference was statistically significant (χ2 = 21.03, P <0.05). The proportion of negative patients who did not consider diet taboo was the highest (32.22%, 29/90), the most obvious was in males. 23.33% (21/90) of them were vaccinated in advance or postponed, 31.25% (10/32). There was no significant difference in the effect of season and gender on immune effect (P> 0.05). Conclusions Timely, full and sufficient vaccination of rabies vaccine can effectively protect the health. Severely injured patients after injection of HRIG, and then the whole immune effect was significant. Diet, wound treatment, physical or immunosuppressive agents affect the immune effect.