文档介绍：再次麻疹的发病特点和免疫学机制
作者:王凤莲,陈仕珠,许松杰
【摘要】目的研究再次麻疹的发病特点和免疫学机制。方法对连续诊治的36 例再次麻疹患者做流行病学及免疫情况调查, 分析其临床特点。据临床表现分典型(TY)、轻型典型(MT)及轻型非典型(MAT)3型。用ELISA法检测患者急性期及25名有麻疹病史的麻疹密切接触者血清抗-麻疹病毒(MV) IgM、IgG和抗-风疹病毒IgM。结果 ~27()岁,以13~16岁为多,%;其第一次患麻疹年龄1岁以内者27例(%),而25名健康者中仅2例在1岁以内,差异有显著性(P<)。性别间无明显差别。36例中MT 18例(%),MAT 18例(%),无TY麻疹,首诊均误诊。抗-MV IgM均阳性,抗-风疹病毒IgM均阴性。抗-MV IgG 滴度在1:200,1:300,1:400和1:600阳性者分别为7,14,12和3例,其中抗-MV IgG 水平≤1:%为MT麻疹;≥1:%为MAT。抗-MV Ig***平与病情呈显著负相关(P<)。25名有麻疹病史者抗-MV IgG ≤1:400阳性者9例(%),显著低于患者组(%)(P<)。结论(1)1周岁内患麻疹者13年后抗体衰减至可再患麻疹。(2)再次麻疹患者因临床表现不典型及有麻疹病史而极易误诊,需检测抗-MV IgM阳性方可诊断。(3)发病及病情轻重主要取决于体内抗-MV Ig***平。
【关键词】麻疹;临床表现;免疫
Clinical manifestations and immunological mechanism in patients easles
【Abstract】 Objective To study the clinical manifestations and immunological mechanism of second 36 cases easles munological condition and clinical manifestations. The patients ildly typical (MT)and the mildly atypical (MAT) -measles virus (MV) IgM,IgG and anti-rubella IgM in serum al people easles history contacted closely easles (1)The age 13~16 yrs easles onths al people respectively,and differentiation arked bet(P<). Of 36 MT and MAT measles isdiagnosed easles,and ≥1:400 als easles onths may catch second after 13 years old. (2)Second measles is very easy to b