不同剂量乙型病毒性肝炎疫苗母婴阻断效果评价  

Evaluation of hepatitis B vaccination with different dose on blocking mother-to-child transmission

作　　者：姚军[1] 陈永弟[1] 楼滨[2] 任菁菁[2] 

机构地区：[1]浙江省疾病预防控制中心,浙江杭州310051 [2]浙江大学医学院附属第一医院

出　　处：《疾病监测》2010年第12期981-983,共3页Disease Surveillance

基　　金：浙江省卫生厅科研基金资助项目(No.2009A035)~~

摘　　要：目的评价不同剂量重组乙型病毒性肝炎（乙肝）疫苗（hepatitis B vacc ine,HepB）对母亲乙肝病毒表面抗原（HBsAg）阳性新生儿的免疫效果。方法选择2005-2007年孕期或住院分娩时检测HBsAg阳性母亲的新生儿637例,分5、10、20μg三组分别接种相应剂量重组HepB,免后1-6月采血,使用微粒子酶免疫测定法检测HBsAg、化学发光法检测乙肝病毒表面抗体（抗-HBs）。结果 5μg组新生儿HBsAg阳性率为3.80%、抗-HBs阳性率为66.30%;10μg组新生儿HBsAg阳性率为4.64%、抗-HBs阳性率为89.29%;20μg组新生儿HBsAg阳性率为2.89%、抗-HBs阳性率为91.33%。3种剂量免后HBsAg阳性率差异无统计学意义（χ^2=0.881,P=0.644）,抗-HBs阳性率差异有统计学意义（χ^2=53.183,P（0.001）,10μg组和20μg组的抗-HBs阳性率及几何平均浓度明显高于5μg组。结论采用10μg重组酵母HepB或20μg重组HepB（中国仓鼠卵巢细胞,CHO）接种为适宜方案。Objective To evaluate the immunization efficacy of three doses of recombinant hepatitis B vaccine in the newborns whose mothers were HBsAg positive,and provide evidence for the development of immunization protocol.MethodsA total of 637 newborns whose mothers were HBsAg positive during pregnant or childbearing were selected from 2005 to 2007 and were divided into 3 groups to receive 5 μg,10 μg and 20 μg recombinant hepatitis B vaccine at 0,1 and 6 months respectively.Blood samples were taken from them within 1-6 months after vaccination to detect HBsAg by microparticle enzyme immunoassay（MEIA） and anti-HBs by chemiluminescence analysis.Results The HBsAg positive rate was 3.80% for 5 μg group,4.64% for 10 μg group and 2.89% for 20 μg group.The anti-HBs positive rate was 66.30%for 5 μg group,89.29% for 10 μg group and 91.33% for 20 μg group.There was no statistical differences on HBsAg positive rates among three groups（χ^2=0.881,P=0.644）,while the differences on anti-HBs positive rates in three groups were statistically significant（χ^2=53.183,P﹤0.001） and the geometric mean concentrations（GMCs）of the anti-HBs in both 10 μg group and 20 μg group were higher than that in 5 μg group.Conclusion The efficacy of vaccination protocol of 10 μg×3 recombinant yeast derived hepatitis B vaccine and 20 μg×3 recombinant CHO hepatitis B vaccine is optimal.

关 键 词：重组乙型病毒性肝炎疫苗 母婴传播 效果 

分 类 号：R512.62[医药卫生—内科学]