Article(id=1240633247290413201, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1240633237542851387, articleNumber=null, orderNo=null, doi=10.20043/j.cnki.MPM.202311109, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1699200000000, receivedDateStr=2023-11-06, revisedDate=null, revisedDateStr=null, acceptedDate=null, acceptedDateStr=null, onlineDate=1773719616005, onlineDateStr=2026-03-17, pubDate=1716566400000, pubDateStr=2024-05-25, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1773719616005, onlineIssueDateStr=2026-03-17, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1773719616005, creator=13701087609, updateTime=1773719616005, updator=13701087609, issue=Issue{id=1240633237542851387, tenantId=1146029695717560320, journalId=1227665162245664772, year='2024', volume='51', issue='10', pageStart='1729', pageEnd='1920', issueExtLink='null', onlineDate='null', pubDate='null', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=null, createTime=1773719613680, creator=13701087609, updateTime=1773720039302, updator=13701087609, preIssue=null, nextIssue=null, ext={EN=IssueExt(id=1240635022806405370, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1240633237542851387, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1240635022806405371, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1240633237542851387, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null}, startPage=1795, endPage=1799, ext={EN=ArticleExt(id=1240633247701455032, articleId=1240633247290413201, tenantId=1146029695717560320, journalId=1227665162245664772, language=EN, title=Relationship between the walking time of pregnant women and the antibody level of SARS-CoV-2 vaccine, columnId=1228016568949474136, journalTitle=Modern Preventive Medicine, columnName=Child and Adolescent health, Maternal and Child Health, runingTitle=null, highlight=null, articleAbstract=
Objective

To explore the relationship between the walking time of pregnant women and the maintenance of the antibody level of SARS-CoV-2 inactivated vaccine, so as to provide a reference basis for the prevention of pregnant women’s infection and the promotion of maternal and infant health during the normalization management of SARS-CoV-2 pneumonia epidemic.

Methods

In a multicenter cross-sectional study in Guangdong Province, 854 pregnant women who were vaccinated with inactivated SARS-CoV-2 vaccine were included to investigate their demographic characteristics and physical activity, and detect their serum SARS-CoV-2 antibody levels. Multifactor logistic regression model was used to analyze the correlation between the walking time of pregnant women and the positive rate of SARS-CoV-2 antibody.

Results

The positive rates of neutralizing antibody, IgG and IgM of serum SARS-CoV-2 were 44.6%, 46.1% and 3.4% respectively. There was a difference in the positive conversion rate of neutralizing antibodies to SARS-CoV-2 among pregnant women at different walking times(P<0.05), and this difference did not appear in the level of IgG and IgM antibodies(P>0.05). Compared to pregnant women who walked for more than 30 minutes per day, pregnant women who walked for 15~30 minutes per day had a higher NAb positivity rate(OR=1.56, 95%CI:1.09~2.23).

Conclusion

The walking time of pregnant women is related to maintaining the antibody level of SARS-CoV-2 vaccine. The antibody level of pregnant women who walk for 15~30min/d is higher. The walking exercise of pregnant women is beneficial to the immune system. It is suggested that pregnant women should exercise moderately every day to maintain good health.

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目的

探索孕妇步行时间与维持新型冠状病毒灭活疫苗抗体水平之间的关系,为新型冠状病毒肺炎疫情常态化管理期间预防孕妇感染,促进母婴健康提供参考依据。

方法

在广东省内一项多中心横断面研究纳入854名接种新型冠状病毒灭活疫苗的孕妇,调查孕妇的人口学特征和身体活动情况,并检测其血清中新型冠状病毒抗体水平。运用多因素logistic回归模型对孕妇步行时间和新型冠状病毒抗体阳性率进行关联性分析。

结果

血清新型冠状病毒中和抗体、IgG和IgM阳性率分别为44.6%、46.1%、3.4%。不同步行时间孕妇的新型冠状病毒中和抗体阳转率存在差异(P<0.05),这种差异在IgG、IgM抗体水平未显现(P>0.05)。相较于步行时间>30 min/d的孕妇,步行15~30 min/d的孕妇NAb阳转率更高(OR=1.56,95%CI:1.09~2.23)。

结论

孕妇步行时间与维持新型冠状病毒疫苗抗体水平存在关联,步行时间15~30 min/d孕妇抗体水平更高,孕妇步行运动对免疫系统有益处,建议孕妇每日进行适量运动,以保持良好的健康状况。

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曾霞,E-mail:
, copyrightStatement=本刊刊出的所有文章不代表中华预防医学会和本刊编委会的观点,除非特别声明。, copyrightOwner=中华预防医学会和四川大学华西公共卫生学院, extLink=null, articleAbsUrl=null, sourceXml=qS5fS8ZJQJ260AaqFOur9w==, magXml=7bFECuQeRqT6beulRgsAaQ==, pdfUrl=null, pdf=15M4S3MFKOoktgWMENClHw==, pdfFileSize=630677, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=null, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=gJ//pm3OJPjv6+5G2qXdEw==, mapNumber=null, authorCompany=null, fund=null, authors=

罗颖琪(1998—),女,硕士在读,研究方向:公共卫生

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Nature Medicine, 2021, 27(7): 1205-1211., articleTitle=Neutralizing antibody levels are highly predictive of immune protection from symptomatic SARS-CoV-2 infection, refAbstract=null)], funds=[Fund(id=1240633254668194339, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240633247290413201, awardId=SL2022A04J00361, language=CN, fundingSource=广州市科技局(SL2022A04J00361), fundOrder=null, country=null), Fund(id=1240633254773051945, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240633247290413201, awardId=2022TDZ21, language=CN, fundingSource=广东省药品监督管理局(2022TDZ21), fundOrder=null, country=null)], companyList=[AuthorCompany(id=1240633248238325998, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240633247290413201, xref=null, ext=[AuthorCompanyExt(id=1240633248246714610, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240633247290413201, companyId=1240633248238325998, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=School of Public Health, Guangdong Pharmaceutical University, Guangzhou, Guangdong 510310, China), AuthorCompanyExt(id=1240633248259297521, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240633247290413201, companyId=1240633248238325998, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=广东药科大学公共卫生学院,广东 广州 510310)])], figs=[ArticleFig(id=1240633252600402428, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240633247290413201, language=EN, label=Table 1, caption=

Basic information description of pregnant women in different walking time groups[n(%)]

, figureFileSmall=null, figureFileBig=null, tableContent=
因素步行时间(min/d)χ2P
<1515~30>30
年龄(岁)6.1170.047
<35183(24.43)295(39.39)271(36.18)
≥3517(16.19)38(36.19)50(47.62)
学历8.3450.214
初中及以下55(25.70)78(36.45)81(37.85)
高中44(24.31)63(34.81)74(40.88)
大专70(24.39)110(38.33)107(37.28)
本科及以上31(18.02)82(47.67)59(34.30)
月人均收入(元)4.0710.667
<2 50037(27.41)46(34.07)52(38.52)
2 500~4 00064(24.33)97(36.88)102(38.78)
4 001~6 00063(21.65)119(40.89)109(37.46)
6 001~10 00036(21.82)71(43.03)58(35.15)
吸烟5.4360.045
1(16.68)5(83.33)0(0.00)
199(23.47)328(38.68)321(37.85)
饮酒4.0850.116
1(20.00)4(80.00)0(0.00)
199(23.44)329(38.75)321(37.81)
BMI(kg/m26.6460.156
<18.542(25.93)59(36.43)61(37.65)
18.5~24.9125(23.95)214(41.00)183(35.06)
>24.933(19.41)60(35.29)77(45.29)
疫苗接种时间(周)14.2190.007
<2464(29.09)85(38.64)71(32.27)
24~32105(24.65)156(36.62)165(38.73)
>3231(14.90)92(44.23)85(40.87)
接种情况196.467<0.001
接种一针15(18.29)30(36.59)37(45.12)
接种两针155(23.77)251(38.50)246(37.73)
接种三针30(25.00)52(43.33)38(31.67)
), ArticleFig(id=1240633252776563203, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240633247290413201, language=CN, label=表1, caption=

不同步行时间组孕妇基本情况描述[n(%)]

, figureFileSmall=null, figureFileBig=null, tableContent=
因素步行时间(min/d)χ2P
<1515~30>30
年龄(岁)6.1170.047
<35183(24.43)295(39.39)271(36.18)
≥3517(16.19)38(36.19)50(47.62)
学历8.3450.214
初中及以下55(25.70)78(36.45)81(37.85)
高中44(24.31)63(34.81)74(40.88)
大专70(24.39)110(38.33)107(37.28)
本科及以上31(18.02)82(47.67)59(34.30)
月人均收入(元)4.0710.667
<2 50037(27.41)46(34.07)52(38.52)
2 500~4 00064(24.33)97(36.88)102(38.78)
4 001~6 00063(21.65)119(40.89)109(37.46)
6 001~10 00036(21.82)71(43.03)58(35.15)
吸烟5.4360.045
1(16.68)5(83.33)0(0.00)
199(23.47)328(38.68)321(37.85)
饮酒4.0850.116
1(20.00)4(80.00)0(0.00)
199(23.44)329(38.75)321(37.81)
BMI(kg/m26.6460.156
<18.542(25.93)59(36.43)61(37.65)
18.5~24.9125(23.95)214(41.00)183(35.06)
>24.933(19.41)60(35.29)77(45.29)
疫苗接种时间(周)14.2190.007
<2464(29.09)85(38.64)71(32.27)
24~32105(24.65)156(36.62)165(38.73)
>3231(14.90)92(44.23)85(40.87)
接种情况196.467<0.001
接种一针15(18.29)30(36.59)37(45.12)
接种两针155(23.77)251(38.50)246(37.73)
接种三针30(25.00)52(43.33)38(31.67)
), ArticleFig(id=1240633252894003724, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240633247290413201, language=EN, label=Table 2, caption=

COVID-19 antibody level of pregnant women in different walking time groups[n(%)]

, figureFileSmall=null, figureFileBig=null, tableContent=
因素步行时间(min/d)χ2P
<1515~30>30
中和抗体9.2450.010
111(23.46)165(34.88)197(41.65)
89(23.36)168(44.09)124(32.55)
IgG4.6770.096
109(23.70)165(35.87)186(40.43)
91(23.10)168(42.64)135(34.26)
IgM0.9921.000
193(23.39)322(39.03)310(37.58)
7(24.14)11(37.93)11(37.93)
), ArticleFig(id=1240633254345232910, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240633247290413201, language=CN, label=表2, caption=

不同步行时间组孕妇新型冠状病毒抗体水平情况[n(%)]

, figureFileSmall=null, figureFileBig=null, tableContent=
因素步行时间(min/d)χ2P
<1515~30>30
中和抗体9.2450.010
111(23.46)165(34.88)197(41.65)
89(23.36)168(44.09)124(32.55)
IgG4.6770.096
109(23.70)165(35.87)186(40.43)
91(23.10)168(42.64)135(34.26)
IgM0.9921.000
193(23.39)322(39.03)310(37.58)
7(24.14)11(37.93)11(37.93)
), ArticleFig(id=1240633254445896212, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240633247290413201, language=EN, label=Table 3, caption=

Logistic regression model for physical activity and neutralizing antibodies in pregnant women

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步行时间(min/d)模型1模型2
OR(95%ClPOR(95%ClP
>301.001.00
<150.54(0.39~0.77)0.1891.10(0.72~1.66)0.680
15~301.80(0.77~4.19)0.2671.56(1.09~2.23)0.015
), ArticleFig(id=1240633254538170908, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240633247290413201, language=CN, label=表3, caption=

身体活动与孕妇新型冠状病毒中和抗体的logistic回归模型

, figureFileSmall=null, figureFileBig=null, tableContent=
步行时间(min/d)模型1模型2
OR(95%ClPOR(95%ClP
>301.001.00
<150.54(0.39~0.77)0.1891.10(0.72~1.66)0.680
15~301.80(0.77~4.19)0.2671.56(1.09~2.23)0.015
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孕妇步行时间与新型冠状病毒疫苗抗体水平的关系研究
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罗颖琪 , 陈青松 , 陈保兰 , 戴颖诗 , 曾霞
现代预防医学 | 儿少卫生与妇幼保健 2024,51(10): 1795-1799
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现代预防医学 | 儿少卫生与妇幼保健 2024, 51(10): 1795-1799
孕妇步行时间与新型冠状病毒疫苗抗体水平的关系研究
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罗颖琪, 陈青松, 陈保兰, 戴颖诗, 曾霞
作者信息
  • 广东药科大学公共卫生学院,广东 广州 510310
  • 罗颖琪(1998—),女,硕士在读,研究方向:公共卫生

通讯作者:

曾霞,E-mail:
Relationship between the walking time of pregnant women and the antibody level of SARS-CoV-2 vaccine
Ying-qi LUO, Qing-song CHEN, Bao-lan CHEN, Ying-shi DAI, Xia ZENG
Affiliations
  • School of Public Health, Guangdong Pharmaceutical University, Guangzhou, Guangdong 510310, China
出版时间: 2024-05-25 doi: 10.20043/j.cnki.MPM.202311109
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目的

探索孕妇步行时间与维持新型冠状病毒灭活疫苗抗体水平之间的关系,为新型冠状病毒肺炎疫情常态化管理期间预防孕妇感染,促进母婴健康提供参考依据。

方法

在广东省内一项多中心横断面研究纳入854名接种新型冠状病毒灭活疫苗的孕妇,调查孕妇的人口学特征和身体活动情况,并检测其血清中新型冠状病毒抗体水平。运用多因素logistic回归模型对孕妇步行时间和新型冠状病毒抗体阳性率进行关联性分析。

结果

血清新型冠状病毒中和抗体、IgG和IgM阳性率分别为44.6%、46.1%、3.4%。不同步行时间孕妇的新型冠状病毒中和抗体阳转率存在差异(P<0.05),这种差异在IgG、IgM抗体水平未显现(P>0.05)。相较于步行时间>30 min/d的孕妇,步行15~30 min/d的孕妇NAb阳转率更高(OR=1.56,95%CI:1.09~2.23)。

结论

孕妇步行时间与维持新型冠状病毒疫苗抗体水平存在关联,步行时间15~30 min/d孕妇抗体水平更高,孕妇步行运动对免疫系统有益处,建议孕妇每日进行适量运动,以保持良好的健康状况。

新型冠状病毒灭活疫苗  /  步行时间  /  抗体  /  孕妇
Objective

To explore the relationship between the walking time of pregnant women and the maintenance of the antibody level of SARS-CoV-2 inactivated vaccine, so as to provide a reference basis for the prevention of pregnant women’s infection and the promotion of maternal and infant health during the normalization management of SARS-CoV-2 pneumonia epidemic.

Methods

In a multicenter cross-sectional study in Guangdong Province, 854 pregnant women who were vaccinated with inactivated SARS-CoV-2 vaccine were included to investigate their demographic characteristics and physical activity, and detect their serum SARS-CoV-2 antibody levels. Multifactor logistic regression model was used to analyze the correlation between the walking time of pregnant women and the positive rate of SARS-CoV-2 antibody.

Results

The positive rates of neutralizing antibody, IgG and IgM of serum SARS-CoV-2 were 44.6%, 46.1% and 3.4% respectively. There was a difference in the positive conversion rate of neutralizing antibodies to SARS-CoV-2 among pregnant women at different walking times(P<0.05), and this difference did not appear in the level of IgG and IgM antibodies(P>0.05). Compared to pregnant women who walked for more than 30 minutes per day, pregnant women who walked for 15~30 minutes per day had a higher NAb positivity rate(OR=1.56, 95%CI:1.09~2.23).

Conclusion

The walking time of pregnant women is related to maintaining the antibody level of SARS-CoV-2 vaccine. The antibody level of pregnant women who walk for 15~30min/d is higher. The walking exercise of pregnant women is beneficial to the immune system. It is suggested that pregnant women should exercise moderately every day to maintain good health.

Inactivated SARS-CoV-2 vaccine  /  Walking time  /  Antibodie  /  Pregnant woman
罗颖琪, 陈青松, 陈保兰, 戴颖诗, 曾霞. 孕妇步行时间与新型冠状病毒疫苗抗体水平的关系研究. 现代预防医学, 2024 , 51 (10) : 1795 -1799 . DOI: 10.20043/j.cnki.MPM.202311109
Ying-qi LUO, Qing-song CHEN, Bao-lan CHEN, Ying-shi DAI, Xia ZENG. Relationship between the walking time of pregnant women and the antibody level of SARS-CoV-2 vaccine[J]. Modern Preventive Medicine, 2024 , 51 (10) : 1795 -1799 . DOI: 10.20043/j.cnki.MPM.202311109
疫苗是一种药物,当注射到体内时,它可以增加免疫力和抗体的数量,为抵抗病毒感染做好准备[1]。随着新型冠状病毒肺炎疫情在全球大流行,疫苗接种作为预防疾病的重大措施,除非妊娠个体外,世界卫生组织也推荐孕妇接种新型冠状病毒疫苗[2]。然而孕妇这一群体具有特殊性,其新型冠状病毒疫苗的接种不仅关乎孕妇本人的健康状况,甚至会影响其子代健康。既往研究证据显示:孕妇接种新型冠状病毒疫苗的效用易受其生活方式因素的影响,如身体活动水平。孕妇积极参与身体活动不仅能降低孕期患病风险、控制体重增长[3-5],另外身体活动可以增强外周血单核细胞(PBMC)的线粒体功能和能力,外周血单核细胞(PBMC)是由造血干细胞(HSC)在骨髓中产生的各种特殊免疫细胞,它们共同作用以保护我们的身体免受有害病原体的侵害,进而能更好的维持和改善免疫功能[1,6-7]。在接种疫苗的环境中,运动可能是免疫反应的佐剂[8],并且免疫效果受到运动的时长和强度的影响,长时间的高强度运动,免疫受到抑制,个体更易发生机会性感染[9]。最近的一项研究结果显示:接种流感疫苗的老年妇女连续两周每天步行18 000步比少于10 000步的妇女具有更大的免疫反应[10]。步行作为孕妇人群最常见的身体活动之一[11],对孕妇的健康状况起重要作用。既往有研究发现,定期进行步行运动的孕妇能更好的控制体重,增强心肺功能,减少分娩疼痛、降低剖宫产及巨大儿的发生率[12],然而目前尚未发现针对孕妇步行时间与维持新型冠状病毒疫苗抗体水平之间的关系的研究。因此,本研究旨在了解孕妇接种新型冠状病毒灭活疫苗后抗体水平的情况,进而探索孕妇步行时间与维持新型冠状病毒灭活疫苗抗体水平之间的关系,为新型冠状病毒肺炎疫情常态化管理促进母婴健康提供思路。
选取2021年12月至2022年月3日期间在深圳市龙华区妇幼保健院、广州市白云区妇幼保健院、东莞市人民医院就诊的的孕妇,向其告知研究目的及内容并签署书面知情同意书,共纳入854名对象,纳入标准:①孕前或孕期至少接种过一剂新型冠状病毒灭活疫苗;②年龄≥18岁;③知情同意参加本次调查。排除标准:①过去被诊断患有新型冠状病毒感染;②多胎妊娠;③接种状况、运动情况和妊娠随访信息未知;④孕前患有严重基础疾病;⑤存在遗传病史。该研究在开始前获得了广东药科大学公共卫生学院医学伦理审查委员会的批准(IRB·2021-01)。
调查员须经过专业培训并且考核合格,熟悉问卷内容,采用一对一询问的方式进行问卷调查,并在各环节进行质量控制。采用统一规范的调查问卷,入组阶段对孕妇进行问卷调查,收集年龄(以世卫组织规定的是否高龄妊娠作为年龄的分层)、体重指数(BMI)、孕产次、吸烟、饮酒等人口学资料和基本行为生活方式,疫苗接种相关信息,包括接种剂次、孕前/孕期接种和疫苗接种时间(定义为接种最后一剂疫苗到采血之间的时间间隔)。采用Excel建立数据库,对每一份问卷进行逻辑检查及核对,保证数据录入的准确度与可靠性。
在孕妇入组后采集5 ml的静脉血,离心并分离血清,储存于-80℃低温冰箱。使用微量细胞病变中和试验方法对中和抗体水平进行测定,血清样本在56℃下灭活30 min,对样本进行四倍稀释,稀释后的血清样品与等体积(50 μl)的 SARS-CoV-2活病毒悬液一起孵育,置36.5℃,5%CO2培养箱中孵育2 h。然后将Vero细胞(1.0~2.0×105个细胞/ml)加入微孔板中的血清-病毒悬液中,一式两份,在36.5℃,5%CO2培养箱内培养5 d。在显微镜下记录细胞病理学效应,中和抗体滴度的稀释倍数为1:8,<1:8 为阴性,≥1:8 为阳性。利用化学发光法(博奥赛斯生物科技有限公司,重庆,中国)对新型冠状病毒IgG和IgM抗体进行检测,单位为 S/CO,<1.00 S/CO 被认为是阴性的,>1.00-S/CO被认为是阳性。文中所涉及的的抗体检测均是委托专业机构按照标准操作完成,抗体数据与Fu等人[13]在Gut发表的文章共用同一数据库,符合生物安全标准。
使用基于现场问卷的调查,根据美国妇产科学院(ACOG)建议:所有无运动禁忌证的孕妇都应积极活动,并在一周中的大部分时间进行至少30 min的轻至中度运动[11],以及怀孕期间的实用运动建议:孕妇应从每周3次15 min的运动开始,并根据耐受性进展[14]。将受试者步行时间被分为三组,分别为<15、15~30、>30 min/d组。
应用SPSS 21.0软件进行统计分析,人口学特征采用描述性分析。采用卡方检验比较不同步行组孕妇基本情况及新型冠状病毒抗体水平情况。并且运用logistic回归模型分析孕妇身体活动情况与新型冠状病毒抗体阳性率关联性,检验水准α=0.05。
不同步行时间孕妇的年龄、吸烟情况、疫苗接种时间、接种情况存在差异(P<0.05),而其在学历水平、月人均收入、饮酒情况、不同BMI组别间无显著统计学差异(P>0.05),见表1
血清新型冠状病毒中和抗体、IgG和IgM阳性率分别为44.6%、46.1%、3.4%。不同步行时间孕妇的新型冠状病毒中和抗体阳转率存在差异(χ2=9.245,P=0.010),这种差异在IgG、IgM抗体水平未显现(P>0.05)。见表2
表3所示,调整了年龄、吸烟、饮酒、BMI、接种剂次、采血时间后,我们发现:相较于步行时间>30 min/d,步行时间为15~30 min/d孕妇的中和抗体水平更高(OR=1.56,95%CI: 1.09~2.23)。
本研究探索了新型冠状病毒灭活疫苗在不同步行时间孕妇中的新型冠状病毒抗体水平的维持效果。结果显示,血清新型冠状病毒中和抗体、IgG和IgM阳性率分别为44.6%、46.1%、3.4%,步行时间与新型冠状病毒中和抗体阳转率存在关联,孕妇步行15~30 min/d比步行>30 min/d中和抗体水平高,因此,孕妇每日应进行适量运动,以维持新型冠状病毒中和抗体水平,从而更好的维持良好的健康状况。
关于身体活动与接种新型冠状病毒疫苗后抗体水平的关联,国内外开展过多项队列研究,研究结果仍存在争议。本研究在调整了年龄、吸烟、饮酒、BMI、接种剂次、采血时间这些混杂因素后得知:相较于步行时间>30 min/d的孕妇,步行15~30 min/d的孕妇NAb阳转率更高。有研究表示:中和抗体是浆细胞分泌的蛋白质,是防御机制的重要组成部分,中和抗体可以通过与刺突蛋白成分结合来降低病毒载量[15]。但免疫接种产生的抗体水平因人而异,中和抗体滴度较低的疫苗接种者极易发生再感染[16-17]。身体活动被证实可作为免疫功能的佐剂[18]。一项关于体育活动对新型冠状病毒mRNA疫苗抗体水平的研究表明,对照组连续一个月每天步行少于5 000步,在运动期间休息20 min,而治疗组在同一时间和运动任务期间每天步行超过12 000步,与对照组相比,治疗组的抗体水平显著下降[1]。另外,一项系统评价表明,健康参与者的免疫系统受到急性运动的影响,免疫细胞在运动后没有改变或减少,急性运动或体力活动可能在短期内损害免疫功能[19]。这些均支持我们对孕妇新型冠状病毒抗体水平的研究发现。但也有研究认为急性运动可以改善免疫监视,例如增强抗菌和抗病毒能力,而不是抑制免疫力[18]。一项哺乳期妇女体力活动的研究也表示,体力活动对母乳和哺乳期妇女血清中新型冠状病毒抗体的水平有益,体力活动强度是这种关系的最重要因素[20]
运动可以通过改善线粒体健康,以维持正常免疫功能[21]。另外运动免疫增强假说表示,运动能将免疫细胞重新部署到外周组织(例如粘膜表面)以进行免疫监视,这些免疫细胞可以识别和根除感染病原体的细胞,或受损、恶性的细胞[22]。骨骼肌已经成为免疫系统的调节因子,运动时,用力肌肉产生和分布免疫细胞,通过产生肌因子,如 IL-6、IL-10、IL-15和IL- 7,IL-6、IL-10促进单核细胞和巨噬细胞产生调节介质,IL-7 是胸腺细胞生成所必需的,IL-15和IL- 7两者都对初始T细胞增殖和存活有保护作用,进而更好的维持免疫应答[21,23-24]。身体活动作为改善免疫功能的佐剂,定期进行身体活动不仅能降低大部分老年慢性病的发病率,还会减少病毒和细菌感染等传染病,以及癌症和慢性炎症性疾病等非传染性疾病的发生[18]。一项流感疫苗免疫反应研究表明,与非运动对照组相比,定期进行中度或剧烈运动训练的65~85岁男性具有更高的抗体反应[25]。另外一项早期研究将62岁或以上的成年人分为三组:活跃(每周进行3次或以上至少20 min的剧烈运动)、中度活跃(定期运动但强度、频率和或持续时间较低)、久坐不动(非锻炼者)。接种流感疫苗两周后,活跃成人的流感IgG和IgM滴度高于久坐不动成人,外周血单核细胞对抗原特异性刺激的反应也更高[26]。因此建议孕妇在新型冠状病毒肺炎常态化管理期间保持身体活动,合理进行低等强度运动(如散步),以及中等强度运动(如快步走、瑜伽、打太极等)。
鉴于孕妇感染新型冠状病毒与死产、孕产妇死亡及合并症风险增加有关[3],并且新型冠状病毒感染的进展主要取决于病毒在与血管紧张素转换酶2(ACE2)结合后进入宿主细胞,孕妇更易受到该因素影响而感染新型冠状病毒,ACE2不仅能在细胞膜上表达,还可能在整个妊娠期间在胎盘中大量表达[27]。尽管在怀孕和哺乳期间接种新型冠状病毒疫苗的理论风险有限,但目前的疫苗在非妊娠个体中具有较好的安全性。孕期接种新型冠状病毒疫苗可能会与孕期建议接种百白破疫苗一样为新生儿带来类似的益处[28],孕期接种新型冠状病毒疫苗可能对母体以及婴儿健康更有利。并且目前世界卫生组织建议孕妇、产后和哺乳期妇女接种新型冠状病毒疫苗[2]。因此在新型冠状病毒肺炎常态化管理期间,孕妇为了更好的促进健康,应该更加注重个人的防护,积极进行新型冠状病毒疫苗的免疫接种,同时进行适量的身体活动。
尽管本研究孕妇疫苗接种时间与采血时间间隔较长,但是据2021年Nature Medicine的研究结果表示[29],50% 预防重症感染的中和抗体水平相当于恢复期受试者平均滴度的 3.0%(相当于约8.10 IU/ml),本研究孕妇中和抗体滴度≥8 IU/ml定义为血清抗体阳性,因此血清抗体阳性的孕妇具有新型冠状病毒保护效力,本研究结果较为可靠。但本研究也存在以下局限。首先,步行时间是采用主观问卷收集数据,可能存在回忆偏倚,但本研究的问卷是采用一对一的形式开展,调查方式较为精细,能最大限度地降低偏倚。其次,本研究为横断面研究,无法探明孕妇步行时间与新型冠状病毒抗体水平之间的因果关系。再次,本研究中的孕妇在产检及就诊前虽均持有48小时核酸检验阴性证明,但仍无法完全排除隐性感染者。最后,本研究仅获取了步行时间的数据,维度较为单一,未对步行运动的强度及步数进行量化,这些因素可能影响结果的稳定性。
综上所述,本研究通过探索孕妇步行时间与维持新型冠状病毒灭活疫苗抗体水平之间的关系,发现孕妇步行时间与维持新型冠状病毒灭活疫苗抗体水平存在关系,并且步行15~30 min/d的孕妇中和抗体阳转率更高。因此建议孕妇每日进行适量运动,以保持良好的健康状况。
  • 广州市科技局(SL2022A04J00361)
  • 广东省药品监督管理局(2022TDZ21)
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doi: 10.20043/j.cnki.MPM.202311109
  • 接收时间:2023-11-06
  • 首发时间:2026-03-17
  • 出版时间:2024-05-25
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  • 收稿日期:2023-11-06
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广州市科技局(SL2022A04J00361)
广东省药品监督管理局(2022TDZ21)
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    广东药科大学公共卫生学院,广东 广州 510310

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2种不同金属材料的力学参数

Family
属数
Number of
genus
种数
Number of
species
占总种数比例
Percentage of
total species (%)

Genus
种数
Number of
species
占总种数比例
Percentage of total
species (%)
鹅膏菌科Amanitaceae 2 11 5.26 鹅膏菌属 Amanita 10 4.78
小菇科 Mycenaceae 2 12 5.74 丝盖伞属 Inocybe 5 2.39
多孔菌科 Polyporaceae 8 14 6.70 蜡蘑属 Laccaria 5 2.39
红菇科 Russulaceae 3 23 11.00 小皮伞属 Marasmius 6 2.87
小菇属 Mycena 11 5.26
光柄菇属 Pluteus 5 2.39
红菇属 Russula 17 8.13
栓菌属 Trametes 5 2.39
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