文章摘要
丁亚兴,毛乃颖,许文波,高志刚,张颖.IgG抗体亲和力试验判定麻疹病例的价值[J].中华流行病学杂志,2021,42(3):544-548
IgG抗体亲和力试验判定麻疹病例的价值
Contribution of measles virus IgG antibody avidity assay to the identification of measles cases
收稿日期:2019-05-27  出版日期:2021-03-29
DOI:10.3760/cma.j.cn112338-20190527-00373
中文关键词: 麻疹;IgM抗体;IgG抗体;亲和力试验
英文关键词: Measles;IgM antibody;IgG antibody;Avidity assay
基金项目:天津市卫生健康科技项目(ZC20200)
作者单位E-mail
丁亚兴 天津市疾病预防控制中心免疫规划科 300011  
毛乃颖 中国疾病预防控制中心病毒病预防控制所, 北京 102206  
许文波 中国疾病预防控制中心病毒病预防控制所, 北京 102206  
高志刚 天津市疾病预防控制中心免疫规划科 300011  
张颖 天津市疾病预防控制中心免疫规划科 300011 cdczhangying@sina.com 
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中文摘要:
      目的 评价麻疹IgG抗体亲和力试验对判定麻疹病例的价值。方法 以中国疾病预防控制信息系统2013-2015年天津市麻疹实验室确诊病例和麻疹排除病例为研究对象。回顾性追溯保存的病例血清,开展麻疹IgG抗体亲和力试验,重新对麻疹排除病例进行归类。结果 共收集到326例麻疹病例血标本,其中实验室确诊病例267例,排除病例59例,≥20岁病例占92.33%(301/326)。麻疹IgG抗体亲和力试验显示,确诊病例和排除病例中麻疹IgG高亲和力抗体的比例分别为66.95%(158/236)和91.23%(52/57),差异有统计学意义(χ2=13.33,P<0.001)。根据判定标准,15.25%(9/59)排除病例被重新判定为麻疹病例,其中8例是高亲和力抗体,有含麻疹成分疫苗(MCV)免疫史,判定为继发性免疫失败病例;1例为低亲和力抗体,有典型的麻疹临床症状,无MCV免疫史。结论 麻疹IgG抗体亲和力试验能够提供有参考意义的血清学证据,可以减少麻疹急性期血清学诊断中由于IgM抗体假阴性而造成的错误排除。
英文摘要:
      Objective To evaluate the value of measles IgG antibody avidity assay in identifying the measles cases. Methods Data from the Measles Surveillance Information System was used to collect laboratory confirmed or discarded cases in 2013-2015, and then tracing back the blood specimens from all measles network laboratories in Tianjin. Measles antibody avidity assay was used to detect and to redefine cases from the discarded ones. Results A total of 326 measles cases including 267 laboratory-confirmed and 59 discarded cases were enrolled into this study, with 92.33% (301/326) of them aged ≥ 20 years. Result from the measles IgG antibody avidity assay showed that the ratio of high-avidity was 91.23%(52/57) of the discarded cases, which was significantly higher than 66.95% (158/236) of the laboratory confirmed cases (χ2=13.33, P<0.001). According to the case criterion, 15.25% (9/59) of the discarded cases were redefined as measles cases. Eight out of the nine cases were high-avidity with measles containing vaccine (MCV) vaccination history that named as SVF cases. One in nine cases with low-avidity was with typical clinical symptomatic measles but with no vaccination history of MCV. Conclusion Measles IgG antibody avidity assay could provide reference serological evidence to reduce the error from those discarded cases caused by false negative results on IgM antibody, when diagnosing the measles cases.
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