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陈化新, 罗兆庄, 张家驹, 张遵宝, 胡美娇, 翁景清, 阮玉华, 朱凤才, 赵铁镪, 刘文雪, 王福兴, 龙清忠, 宋干. 肾综合征出血热疫苗预防效果和免疫策略研究[J]. 中国公共卫生, 1999, 15(7): 561-568.
引用本文: 陈化新, 罗兆庄, 张家驹, 张遵宝, 胡美娇, 翁景清, 阮玉华, 朱凤才, 赵铁镪, 刘文雪, 王福兴, 龙清忠, 宋干. 肾综合征出血热疫苗预防效果和免疫策略研究[J]. 中国公共卫生, 1999, 15(7): 561-568.
Chen Huaxin, . Study on Epidemiological Efficacy and Immunological Strategy of Vaccines against Hemorrhagic Fever with Renal Syndrome[J]. Chinese Journal of Public Health, 1999, 15(7): 561-568.
Citation: Chen Huaxin, . Study on Epidemiological Efficacy and Immunological Strategy of Vaccines against Hemorrhagic Fever with Renal Syndrome[J]. Chinese Journal of Public Health, 1999, 15(7): 561-568.

肾综合征出血热疫苗预防效果和免疫策略研究

Study on Epidemiological Efficacy and Immunological Strategy of Vaccines against Hemorrhagic Fever with Renal Syndrome

  • 摘要: “八五”?“九五”期间连续观察肾综合征出血热(HFRS)沙鼠肾细胞Ⅰ型灭活疫苗(简称:沙鼠苗)?乳鼠脑纯化Ⅰ型灭活疫苗(简称:鼠脑苗)和地鼠肾细胞Ⅱ型灭活疫苗(简称:地鼠苗)在HFRS疫区试验人群中的安全性?血清学和预防效果,并提出免疫策略建议。采取现场与实验室结合的方法。现场试验人群采用整群随机分组,分为疫苗接种组和对照组。实验室血清抗体检测采用间接免疫荧光法(IFAT)?微量细胞病变中和试验(MCPENT)?酶联免疫吸附试验(ELISA)和血凝抑制试验(HI)。研究结果表明3种疫苗安全性良好。在接种人群中的中强反应率较低:沙鼠苗为0.56%,地鼠苗1.57%,鼠脑苗3.26%。在接种疫苗的143,581人中,4年内临床上未出现免疫(感染)增强反应的病例。接种组17例病人与对照组362例病人比较,临床类型差异无显著性(P>0.1)。119例疫苗接种者,以IFAT证实,再次自然感染汉坦病毒(HV)后,未出现临床症状。3种疫苗血清学效果较好。从3种疫苗全程基础免疫后14天?1年(和加强免疫后14天)?2年?3年4年时,中和抗体和荧光抗体的抽样检出情况看,在基础免疫后14天和相隔1年加强免疫后14天,中和抗体平均阳转率:沙鼠苗分别为57.81%、70.71%,鼠脑苗51.09%、61.90%,地鼠苗82.46%、80.13%。荧光抗体阳转率:沙鼠苗分别为93.69%、89.04%,鼠脑苗84.27%、83.05%,地鼠苗65.73%、85.00%。两种抗体阳性率增减的动态变化规律性一致。3种疫苗对人群保护效果较高。基础免疫后4年内,平均保护率:地鼠苗97.61%,鼠脑苗94.30%,沙鼠苗为93.77%。免疫策略研究结果表明,同型苗用在同型疫区,型苗用在混合型疫区和型疫区,型苗用在姬鼠型为主混合型疫区,在观察的4年内均取得了满意的预防效果。我国研制的3种肾综合征出血热单价灭活疫苗,经过4年在高发疫区人群中的观察结果证明,安全有效,可以推广应用。并根据研究结果和本病流行特点提出了免疫策略的建议。

     

    Abstract: The trial fields observation on epidemiological efficacy of three kinds of inactivated vaccines against HFRS(type I vaccines purified from tissue culture of Mogolian gerbils bidney;type I vaccines purifid from tissue cluture of mouse brains;type II vaccines prepared from tissue culture of hamster kidney) was carried out in the periods of eighth-five and ninth-five years national medical scientific studies,also the immunological strategy of these vaccines was suggested.The fields following up and expriment testing was cooperated when vaccine groups and control groups were allocated with cluser sampling.Four kinds of antibody testing methods of IFAT,MCPENT,ELISA and HI were operated for evaluating vaccines antibody reaction.The three kinds of vaccines were all safe and the moderate and svere side effects of vaccines were 0.56%,1.57%,3.26% for Mongolian gerbils kidney vaccine,mouse brains vaccine,hamster kidney vaccine respectively.The antibody-depdendent enhancement did not found in 143581 persons received vaccines aftver four years,also there were on statistically differences in clinical manifestations between 17 HFRS cases in vaccine group and 362 HFRS cases in control group (P> 0.10).The 119 inoculated individuals didn t show any clinical symptom while had seroconversion or increase of IFAT antibody titer which could be defined as second infection.The MCPENT and IFAT antibody reactions of three kinds of vaccine were good after 14 days,one year,two years,three years,four years of vaccine received.The seroconversion rates of MCPENT were 57.81% and 70.71%,51.09% and 61.90%,82.46% and 80.13% for Mongolian gerbils kidney vaccine,mouse brains vaccine,hamster kidney vaccine after 14 days of three doses of injection and one year reinforced respectively.The seroconversion rates of IFAT were 93.69% and 89.04%,84.27% and 83.05%,65.73% and 85.00% Mongolian gerbils kidney vaccine,mouse brains vaccine,hamster kidney vaccine after 14 days of three doses of injection and one year reinforced respectively.The change pheno menon of IFAT and MCPENT antibody was similar.The protection rates in trial fields were 93.77%,94.30%,97.61% for Mongoian gerbils kidney vaccine,mouse brains vaccine,hamster kidney vaccine respectively in the four years of three doses,so these vaccines were good epidemio logical efficacy.The immunological strategy of these vaccines showed type I vaccine and type I vaccine against HFRS could be used in the mixed and type I endemic areas,in the mixed of main type I endemic areas respectively.These vaccines can protect HFRS clinical infection effectively in four years of trial fields followed up.The study showed the side effects was slight and epidemiological efficacy was satisfied about three kinds of inactivated vaccines against HFRS produced in China when people were received these vaccines in the high endemic area,so the vaccine could be common inoculated.The immuno logical strategy was suggested according to these research results and epidemiological character of HFRS incidence.

     

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