健康人群中乙肝疫苗无(低)应答者再免疫效果研究  

Study on Effect of Revaccination in Healthy Nonresponders or Hyporesponders to Hepatitis B Vaccine

作　　者：朱建琼[1] 黄振宇[1] 毛东波[1] 李粤荣[1] 

机构地区：[1]广东省东莞市疾病预防控制中心,广东东莞523006

出　　处：《实用预防医学》2008年第6期1764-1768,共5页Practical Preventive Medicine

摘　　要：目的探讨不同年龄段健康人群中乙肝疫苗免疫后无(低)应答者接种不同类型乙肝疫苗的再免疫效果。方法采用分层随机抽样方法,按地域分布选取东莞市五镇区2～4岁、6～8岁、13～15岁和16～40岁四个年龄组健康人群,用ELISA法筛查HBcAb、HBsAg、HBsAb均为阴性且有3针乙肝疫苗免疫史的人员作为再免疫研究对象。采用5μg酵母、10μg酵母、10μgCHO、10μg汉逊酵母、20μgCHO和20μg酵母乙肝疫苗按0、1、6月程序再免疫3剂。结果各种疫苗在人群中的再免疫成功率和抗体水平中位数(mIU/ml)分别为:5μg酵母94.34%和226.53,10μg酵母86.46%和175.36,10μgCHO97.39%和331.44,10μg汉逊酵母91.30%和439.01,20μgCHO99.20%和386.66,20μg酵母89.04%和372.97。各年龄组的再免疫成功率和抗体水平中位数(mIU/ml)分别是:2～4岁组98.25%和353.42,6～8岁组96.80%和320.31,13～15岁组94.67%和262.12,16～40岁组87.76%和305.24。结论年龄、疫苗种类和接种剂量是影响无(低)应答者再免疫效果的主要因素,随年龄的增长再免疫效果下降,更换疫苗种类可提高再免疫效果。Objective To study the effect of revaccination using different hepatitis B vaccines in healthy nonresponders or hyporesponders of different age groups. Methods Multi - stage random sampling method was used, 2-- 4 - year - old, 6--8 - year - old, 13-- 15 - year - old, and 16-40 - year - old healthy individuals had been sampled in five towns according to different districts. The individuals＇ HBV serologic markers were screened by ELISA, the individuals whose HBV serologic markers were all negative and had vaccinated three doses of hepatitis B vaccine would be the revaccination recipients. Six kinds of recombinant Hepatitis B vaccine （yeast - derived or CHO cells） with 5μg, 10μg and 20μg were used for the recipients on a 0 - 1 - 6 - month schedule. Results Successful rates of revaccination and the median of antibody levels （mIU/ ml）in the recipients were 94.34 % and 226.53 in 5μg yeast- derived vaccine group, 86.46 % and 175.36 in 10μg yeast - derived vaccine group, 97.39 % and 331.44 in 10μg CHO cells vaccine group, 91.30 % and 439.01 in 10μg Hansenula yeast - derived vaccine group, 99.20% and 386.66 in 20μg CHO cells vaccine group,89.04% and 372.97 in 20μg yeast- derived vaccine group, 98.25 % and 353.42 in 2-- 4 - year - old group, 96.80 % and 320.31 in 6-- 8 - year - old group, 94.67 % and 262.12 in 13-15 - year - old group, and 87.76 % and 305.24 in 16- 40 - year - old group. Conclusions Age, vaccine and dose are the most important factors to affect the effect of revaccination. There is an age - specific decline in immunogenicity, the effect of revaccination will be improved by changing vaccine.

关 键 词：乙型肝炎 疫苗 无应答 再免疫 

分 类 号：R186[医药卫生—流行病学]