本文選題：麻疹 + 流行特征　； 參考：《石河子大學(xué)》2010年碩士論文

【摘要】：目的： 1.分析2004～2009年新疆生產(chǎn)建設(shè)兵團(tuán)麻疹的流行特征。 2.了解麻疹流行后人群麻疹抗體水平現(xiàn)狀。 3.監(jiān)測(cè)強(qiáng)化免疫前后人群抗體水平變化情況,評(píng)價(jià)強(qiáng)化免疫的效果。 4.為有關(guān)部門(mén)控制麻疹和制訂有關(guān)政策提供重要參考依據(jù)。 方法： 1.收集2004～2009年新疆生產(chǎn)建設(shè)兵團(tuán)麻疹網(wǎng)絡(luò)直報(bào)數(shù)據(jù),用描述流行病學(xué)的方法來(lái)分析麻疹流行特征。 2.用血清流行病學(xué)現(xiàn)況調(diào)查方法調(diào)查麻疹流行后人群抗體水平,以新疆生產(chǎn)建設(shè)兵團(tuán)全人群為研究對(duì)象,按年齡分為12層,每個(gè)年齡層隨機(jī)抽取45～104人,在南、北疆共采取有效血.樣1415份；強(qiáng)化免疫后,跟蹤監(jiān)測(cè)其中451名強(qiáng)化免疫的目標(biāo)兒童(8月齡～6歲兒童),-月后監(jiān)測(cè)到有效血樣414人份。 3.用酶聯(lián)免疫吸附試驗(yàn)(EL ISA)定量檢測(cè)麻疹抗體IgG的濃度。 4.統(tǒng)計(jì)處理利用SPSS13.0軟件包,采用x2檢驗(yàn)、方差分析、非條件Logistic回歸等分析方法。 結(jié)果： 1.2004～2009年,兵團(tuán)共有麻疹病例1545例,平均發(fā)病率為10.00／萬(wàn)；病例主要集中出現(xiàn)在4-5月,麻疹流行周期為4年,8月齡和≥15歲人群麻疹病例構(gòu)成比逐年增高,南疆麻疹平均發(fā)病率(31.43／10萬(wàn))高于北疆(17.51／10萬(wàn))。 2.人群麻疹抗體陽(yáng)性率為85.5%,抗體兒何平均濃度(GMC)為819mIU／ml；不同年齡組人群麻疹抗體水平差異均有統(tǒng)計(jì)學(xué)意義(x2=346.456,F=23.254；P均0.001)；其中2歲和15～34歲人群麻疹抗體水平較低,陽(yáng)性率均低于90%。 3.南、北疆人群麻疹抗體陽(yáng)性率分別為92.0%和79.5%,GMC分別為1126 mIU／m1和586mIU／m1；南疆人群麻疹抗體陽(yáng)性率和GMC均高于北疆(x2=45.802,t=9.848;P均0.001)。 4.多因素非條件Logistic回歸分析結(jié)果顯示人群麻疹抗體陽(yáng)性率與年齡、居住地區(qū)、接種史、患病史因素有關(guān)。 5.麻疹強(qiáng)化免疫效果顯著；強(qiáng)化免疫前,目標(biāo)人群平均陽(yáng)率和GMC分別為88.9%、905mIU／ml；而強(qiáng)化免疫后,陽(yáng)性率和GMC分別提高到99.0%、2410 mIU／ml,易感人群減少了91.3%。強(qiáng)化免疫前后目標(biāo)人群麻疹抗體陽(yáng)性率和GMC差異有統(tǒng)計(jì)學(xué)意義(x2=37.55,t=-21.66；P均0.001)。 結(jié)論： 1.2004～2009年,新疆生產(chǎn)建設(shè)兵團(tuán)麻疹流行特征出現(xiàn)顯著的變化,麻疹流行周期有所延長(zhǎng),8月齡和≥15歲人群麻疹病例構(gòu)成比逐年升高,南疆發(fā)病率高于北疆。 2.新疆生產(chǎn)建設(shè)兵團(tuán)人群麻疹抗體水平不高；2歲和15～34歲的人群是麻疹發(fā)病的高危人群,南疆人群麻疹抗體水平高于北疆。人群年齡、地區(qū)、患病史、接種史影響人群麻疹抗體陽(yáng)性率。 3.本次麻疹疫苗強(qiáng)化免疫效果顯著,有效提高了目標(biāo)人群的麻疹抗體水平,減少了易感兒童。
[Abstract]:Objective: 1. To analyze the epidemic characteristics of measles in Xinjiang production and Construction Corps from 2004 to 2009. 2. To understand the current situation of measles antibody level in the population after measles epidemic. 3. To monitor the changes of antibody level before and after immunization, and to evaluate the effect of enhanced immunization. 4. It provides an important reference for the departments concerned to control measles and formulate relevant policies. Methods: 1. The data of measles network direct report in Xinjiang production and Construction Corps from 2004 to 2009 were collected and the epidemic characteristics of measles were analyzed by means of descriptive epidemiology. 2. The antibody level of the population after measles epidemic was investigated by the method of seroepidemiological investigation. The whole population of Xinjiang production and Construction Corps was taken as the research object. According to the age, 45 104 people were randomly selected from each age group, and effective blood was taken in the south and north of Xinjiang. 1415 samples were collected. Four hundred and forty-four blood samples were collected from 451 target children aged from 8 months to 6 years of age after intensive immunization. 3. Elisa was used to detect the concentration of measles antibody IgG. 4. SPSS13.0 software package was used for statistical processing, x2 test, ANOVA, non-conditional Logistic regression and so on. Results: 1. From 2004 to 2009, there were 1545 measles cases in Bingtuan with an average incidence of 10.00 / 10000. The main cases occurred in April-April, the measles epidemic cycle was 4 years or 8 months old and the proportion of measles cases was increasing year by year among the population aged more than 15 years. The average incidence of measles in southern Xinjiang was 31.43 / 100,000), which was higher than that in northern Xinjiang (1751 / 100000). 2. The positive rate of measles antibody was 85.5 and the average concentration of antibody was 819mIUP / ml. There were significant differences in measles antibody level among different age groups (P = 0.001), among which the measles antibody level was lower in the age group of 2 years and 15 years old than that in the group of 15 and 34 years old, and the positive rate was lower than that in the age group. 3. The positive rates of measles antibody in south and north Xinjiang were 92.0% and 79.5%, respectively, 1126 mIU/m1 and 586 m / m -1, respectively, and the positive rates of measles antibody and GMC in south Xinjiang were higher than those in north Xinjiang (P < 0.05). 4. Multivariate conditional Logistic regression analysis showed that the positive rate of measles antibody was related to age, living area, inoculation history and history of measles. 5. The average positive rate and GMC of the target population were 88.9m / ml and 91.3 m / ml, respectively, but the positive rate and GMC increased to 99.0 ~ 2410 m / ml, respectively, and the susceptible population decreased 91.3%. The positive rate of measles antibody and the difference of GMC in the target population before and after intensive immunization were statistically significant (P = 0.001). Conclusion: 1. From 2004 to 2009, the epidemic characteristics of measles in Xinjiang production and Construction Corps showed significant changes. The measles epidemic cycle was prolonged for 8 months and the proportion of measles cases was increased year by year in the population aged 鈮，

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