全程接种疫苗狂犬病暴露者的免疫效果及其影响因素分析

摘要

目的 探讨全程接种疫苗狂犬病暴露者的免疫效果及其影响因素分析.方法 回顾性分析2013年1月至2014年12月我院门诊1248例全程接种狂犬病疫苗的狂犬病暴露者的临床资料,所有狂犬病暴露者均采用酶联免疫吸附测定法(ELISA)测定抗狂犬病毒抗体,观察并分析其接种疫苗后的免疫效果.对所有狂犬病暴露者进行问卷调查,并对可影响接种疫苗后的免疫效果的因素进行单因素及多因素Logistic回归分析.结果 本研究共检测1248份样品,其中阳性例数为1188例,阳性率为95.19%,男女间的阳性率差异无统计学意义(P>0.05);单因素结果分析显示,年龄、暴露部位、狂犬疫苗接种史、慢性疾病史、接种期间是否抽烟、接种期间是否喝酒和接种期间是否有使用激素或免疫抑制剂均为影响狂犬疫苗接种后免疫效果的相关因素;多因素Logistic回归分析结果显示,年龄、暴露部位、狂犬疫苗接种史、慢性疾病史、接种期间是否有使用激素或免疫抑制剂均为影响狂犬疫苗接种后免疫效果的独立危险因素.结论 狂犬病暴露者接种狂犬病疫苗有助于狂犬病的预防,而对于抗狂犬病毒抗体阴性者,应加强免疫,确保免疫效果.年龄、暴露部位、狂犬疫苗接种史、慢性疾病、接种期间是否有使用激素或免疫抑制剂均为影响狂犬疫苗接种后免疫效果的独立危险因素.%Objective To investigate the immune efficacy and influencing factors of whole course vaccination in rabi -es-exposed persons.Methods Clinical data of 1248 cases of rabies-exposed persons who received whole course vaccination in our outpatient department during January 2013 and December 2014 were retrospectively analyzed.All rabies-exposed persons were de-termined anti-rabies virus antibody using enzyme-linked immunosorbent assay(ELISA)and immune efficacy after vaccination was observed and analyzed.A questionnaire was made among all rabies-exposed persons and possible factors,which may influence im-mune efficacy after vaccination,were analyzed through univariate as well as multivariate Logistic regression analysis.Results In this study,a total of 1248 samples were tested,including 1188 positive cases,with a positive rate of 95.19% and there was no statistically significant difference of positive rate between men and women(P>0.05).The result of univariate analysis showed that age,exposed area,history of rabies vaccination,history of chronic disease,smoking or not during vaccination period,alcohol con-sumption or not during the vaccination period and glucocorticoids or immunosuppressants using or not during vaccination period were all relevant factors influencing immune efficacy after vaccination.The result of multivariate analysis showed that age,exposed area,history of rabies vaccination,history of chronic disease and glucocorticoids or immunosuppressants using or not during vacci -nation period were all independent risk factors influencing immune efficacy after vaccination.Conclusion Inoculation of rabies vaccine in rabies-exposed persons severs the purpose of rabies prophylaxis.As for people with negative anti-rabies virus antibody, they should receive booster immunization to ensure the immune efficacy.Age,exposed area,history of rabies vaccination,history of chronic disease and glucocorticoids or immunosuppressants using or not during vaccination period are all independent risk factors influencing immune efficacy after vaccination.