目的 了解陕西省铜川市健康人群百日咳、白喉、破伤风(百白破)抗体水平,为有效控制百白破提供参考依据.方法 采用分层多级抽样的方法,在铜川市4区(县)随机抽取＜1岁、1～2岁、3～4岁、5～6岁、7～14岁、15 ～19岁、≥20岁健康人群368人,用酶联免疫吸附试验测定百日咳、白喉、破伤风IgG抗体.结果 2011年铜川市健康人群百日咳抗体阳性率为38.04％,抗体几何平均浓度(GMC)为54.56 U/ml；白喉抗体阳性率94.02％,安全保护率60.87％,GMC为1.61 IU/ml；破伤风抗体保护率55.71％,GMC为2.70 IU/ml.结论 铜川市健康人群百日咳IgG抗体阳性率低,7岁以上人群白喉及破伤风抗体保护率较低.预测铜川市近年不会发生白喉及新生儿破伤风疫情,但存在百日咳流行的隐患.故今后应通过加强百日咳的诊断及时规范管理病例,避免传播,还应按免疫程序及时加强免疫,并建议对大年龄组人群接种低白喉、破伤风联合疫苗含量的疫苗.%Objective To understand the immunity levels of pertussis, diphtheria and tetanus among healthy people in Tongchuan, and provide scientific evidence for the effective control of these diseases. Methods Totally 368 healthy people in 7 age groups ( < 1, 1-2, 3-4, 5-6, 7-14, 15-19 and ≥20 years) were selected in 4 districts in Tongchuan by multi-stage stratified sampling and serum samples were taken from them. Enzyme linked immunosorbent assay (ELISA) was conducted to detect pertussis, diphtheria and tetanus antibodies. Results The antibody positive rate to pertussis was 38. 04% with the geometric mean concentration (GMC) of 54. 56 U/ml; the antibody positive rate to diphtheria was 94.02% , antibody protective rate to diphtheria was 60. 87% with the GMC of 1. 61 IU/ml and the antibody protective rate to tetanus was 55. 71% with the GMC of 2. 70 IU/ml. Conclusion The antibody positive rate to pertussis was low in healthy people in Tongchuan, the antibody protective rate to diphtheria and tetanus were low in healthy people aged > 7 years. Outbreaks of diphtheria and neonatal tetanus might not occur recently in Tongchuan, but the potential of pertussis epidemic exist. It is necessary to strengthen the diagnosis of pertussis and timely standardize the case management to prevent the spread of the disease, and it is suggested to conduct diphtheria tetanus booster immunization in older age group.
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