甲型肝炎减毒活疫苗再免疫的研究  

Studies on Re immunization with Live Attenuated Hepatitis A Vaccine

作　　者：刘翌[1,2] 徐志一[1,2] 欧阳佩英[1,2] 赵守军 吴婉贞[1,2] 

机构地区：[1]上海医科大学流行病学教研室 [2]江苏省苏州市卫生防疫站

出　　处：《中华预防医学杂志》1998年第3期162-164,共3页Chinese Journal of Preventive Medicine

基　　金：美国中华医学基金;国家科委"九.五"攻关基金

摘　　要：目的对甲型肝炎减毒活疫苗加强免疫的可能性进行研究。方法分别设置再免疫组、初免疫组和自然感染组。用ＡｂｂｏｔＥＩＡ改良法定性和定量检测血清中的甲型肝炎抗体。结果再免疫后甲型肝炎抗体阳性率和几何平均滴度在２周内升高，与初免疫组抗体阳性率和几何平均滴度缓慢上升至３个月以后达到高峰形成对比。再免疫组和自然感染组对活疫苗免疫反应存在区别，这在研究疫苗免疫持久性时应予考虑。再免疫组初免成功抗体又转阴者，再免疫后抗体阳性率８３３％（１０／１２），显著高于初免疫失败者再免疫后的阳性率５０％（１７／３４），两者又均高于初免疫者（２９６％）。结论再免疫可引起免疫回忆反应，且初免疫成功率直接影响到再免疫的效果。ＡｂｂｏｔＥＩＡ改良法检测血清中甲型肝炎抗体仍低估了原发性免疫反应，需用更为灵敏特异的方法检测疫苗抗体。Objective The possibility of re immunization with a booster dose of live attenuated hepatitis A (HA) vaccine was studied. Methods Children randomly sampled were divided into three groups with re immunization, primary immunization and immunity via natural infection. Antibodies against heaptitis A virus (anti HAV) were detected qualitatively and quantitatively with modified Abbott enzyme immunoassay (EIA). Results Proportion of children with positive anti HAV and its mean geometric titer (GMT) increased within two weeks after re immunization, and as compared, those increased slowly and GMT reached the peak three months after primary immunization. Response to the live attenuated vaccine differed between the groups of re immunization and immunity via natural infection, and should be taken into consideration in studying immune persistence of the vaccine. Proportion of children, who converted negative of their anti HAV after primary immunization, with positive anti HAV after re immunization was 83.3% (10/12), significantly higher than that in those who failed in primary immunization and then were vaccinated again (50%, with 17/34), and that in both of them were higher than in primary immunization (29.6%). Conclusion Reminiscence could be induced by re immunization, and the effects of it depended on primary immunization. Detection of anti HAV with modified Abbott EIA still underestimated primary immune reaction. A more sensitive and specific method for detecting anti HAV after vaccination should be used.

关 键 词：甲型肝炎 减毒活疫苗 再免疫 疫苗 接种 

分 类 号：R512.610.3[医药卫生—内科学]