国产血源性乙肝疫苗在健康儿童中全程接种后23年的效果  

Effect of plasma-derived hepatitis B vaccine 23rd year after a full course of vaccination in healthy young children

作　　者：吴谦[1] 王学良[1] 邓亚丽 王丽荣[1] 高海燕[1] 庄贵华[1] 

机构地区：[1]西安交通大学医学院流行病学与卫生统计学科,710061 [2]陕西省结核病防治研究所

出　　处：《中华预防医学杂志》2011年第10期920-923,共4页Chinese Journal of Preventive Medicine

基　　金：基金项目：国家自然科学基金（30972518）;国家“十一五”科技重大专项（2008ZX10002-001）

摘　　要：目的评价国产血源性乙型肝炎疫苗（乙肝疫苗）接种23年后的免疫原性和预防感染的保护效果。方法1986年在西安市两所乡村小学筛检了261名5～9岁学生，按照分层随机分为疫苗组（126名）和对照组（135名）。2009年进行随访，剔除自行接种者后，疫莳组和对照组分别有81名和75名。对乙型肝炎病毒表面抗体（抗-HBs）〈10mIU／ml及乙型肝炎病毒表面抗原（HBsAg）、乙型肝炎病毒核心抗体（抗-HBe）和乙肝病毒（HBV）DNA阴性者复种1针5μg国产重组疫苗，复种后1个月冉次采血检测抗-HBs。结果消除早期复种和自行接种的影响后，在第23年时，疫曲组48．1％（39／81）的研究对象抗-HBs仍保持在10mIU／ml以上，高于对照组的阳性率[34．7％（26／75）]。疫苗组中84．O％（21／25）的抗-HBs和抗-HBc均阴性的研究对象复种后产生了较强的同忆应答，而埘照组中相似的抗-HBs阳性率为7．5％（3／40）。本次随访未发现乙肝临床病例，但疫苗组和对照组的抗-HBc阳性率分别为16．0％（13／81）和30．7％（23／75）（x2=4．687，P〈0．05）。结论国产血源件乙肝疫苗在健康儿童中全程接种后23年，免疫效果仍维持良好或有免疫记忆；疫苗仍有较好的保护效果。Objective The aim of the study was to evaluate the anti-HBs persistence and the long term preventive efficacy after vaccination 23 years with plasma-derived hepatitis B vaccine. Methods The study consisted of 261 children who were 5 -9 years aged, from two primary schools in two townships of Xi＇an. 126 children were randomly selected as vaccine group, and 135 children in control group. These children were followed up again in 2009. Excluding self-inoculation, the vaccine and control groups were 81 and 75 ,who was used to ask to recall details of their experience for vaccination and liver-related illnesses during past twelve years. Individuals who had anti-HBs titers less 10 mIU/ml, HBsAg,anti-HBc and HBV- DNA all were negative, were given a booster dose vaccine and retest for anti-HBs titer after one month. Results After eliminated the interference of an early booster dose and vaccination outside the study, the positive rate of anti-HBs was 48.1% （39/81 ） in the vaccine group at year 23,higher than 34. 7% （26/75） in control group. At year 23 after primary vaccination,84. 0% （21/25） individuals in the vaccine group whose anti-HBs and anti-HBc both are negative showed a stronger anamnestic response after received a booster dose,while 7.5% （3/40） in the control group. At year 23 after primary vaccination, none clinical case of hepatitis B was found among 194 individuals. However, anti-HBc positive rate in the vaccine group was 16.0% （ 13/81 ） ,while the rate in the control group was 30. 7% （23/75） （ X2 = 4. 687, P 〈 0. 05 ）. Conclusion At 23 years after implemented a full course of plasma-derived hepatitis B vaccine, the recipients of vaccine were maintained anti-HBs at a high level or strong immunological memory.

关 键 词：乙肝病毒 血源性疫苗 免疫记忆 

分 类 号：R186[医药卫生—流行病学]