乙肝疫苗无、弱应答相关因素病例对照研究  

Case-control study on HLA-DRB1*0701,environmental risk factor and non-or hyporesponse to hepatitis B vaccine

作　　者：陈思东[1] 黄晓晖[1] 杨翌[1] 谭剑斌[2] 

机构地区：[1]广东药学院公共卫生学院流行病学教研室,广州510006 [2]广东省疾病预防控制中心

出　　处：《中国公共卫生》2009年第10期1208-1210,共3页Chinese Journal of Public Health

基　　金：广东省自然科学基金(020537)

摘　　要：目的探讨乙肝疫苗无、弱应答与人类白细胞抗原的DRB1＊0701基因位点（HLA-DRB1＊0701）和环境因素之间的关系。方法选取1 342名接种乙肝疫苗后无、弱应答者128人作为病例组,在有应答者中按性别匹配随机抽取128人作为对照组;采用病例对照研究方法,对所有研究对象进行问卷调查,并应用PCR-序列特异引物（SSP）技术检测研究对象的HLA-DRB1＊0701基因。采用SPSS 13.0软件对获取的研究数据进行单因素分析以及多因素Logistic回归分析。结果单因素分析发现,与乙肝疫苗接种无、弱应答相关的环境因素为年龄,OR=2.52,95%CI=1.51-4.21;体质指数（BMI）,OR=2.38,95%CI=1.13-5.02;吸烟,OR=2.15,95%CI=1.08-4.28;饮茶,OR=0.32,95%CI=0.10-0.99。携带HLA-DRB1＊0701基因者发生无、弱应答的风险为不携带此基因的4.83倍（95%CI=1.76-13.24）;多因素Logistic回归分析最终进入模型的因素：年龄,OR=2.12,95%CI=1.24-3.63;BMI,OR=2.21,95%CI=1.04-4．72；HLA—DRB1＊0701基因，OR=4．08，95％（21=1．45—11．46。结论乙肝疫苗接种无、弱应答的发生与多种因素有关。Objective To confirm the association between HLA-DRB1 ＊ 0701 and environrnenmtal factor such as smoking,drinking with the non- or hyporesponse to hepatitis B vaccine. Methods A case-control study included 128 non-or hyporesponders and 128 responders from 1 342 healthy adults who were subjected to a standard course of immunization with recombinant hepatitits B vires vaccine. All subjects were investigated with a uniform questionnaire. HLA- DRB1 ＊ 0701 genes was detected with ploymerase chain reaction-sequence specific primes （PCR-SSP）. The data were analysed with SPSS 13.0 software. Results Univariate analysis indicated that age （ OR = 2. 52,95 % CI 1.51 - 4. 21 ）, BMI （ OR = 2. 38,95 % CI 1.13 - 5.02 ）, smoking （ OR = 2. 15,95 % CI 1.08 - 4. 28 ） and drinking tea （ OR = 0. 32,95 % CI 0. 10 -0.99） were associated with non- or hyporesponse. The DRB1 ＊ 0701 allele was found at a ratio of 16. 4% in the non-or hyporesponders which was significant when compared with the responders （3. 9 %, χ^2 = 10. 959, P = 0. 002, OR = 4. 83 ）. The results of multivariate logistic regression showed that only 3 factors entered the model, including age （OR = 2. 12,95 % CI 1.24 - 3.63 ）, BMI （ OR = 2. 21,95 % C1 1.04 - 4. 72 ）, DRB 1 ＊ 0701 （ OR = 4. 08,95 % CI 1.45 - 11.46 ）. Conclusion Many factors were associated with non- or hyporesponse to hepatitis B raccine.

关 键 词：乙肝疫苗 无、弱应答 人类白细胞抗原 环境因素 

分 类 号：R186[医药卫生—流行病学]