乙肝疫苗接种无、弱应答与遗传因素关系  

Relationship between genetic factor and non and hypo-response to hepatitis B vaccine

作　　者：刘蓬勃[1,4] 徐慧文[2] 王学良[2] 李辉[3] 庄贵华[2] 乌正赉[3] 张孔来 

机构地区：[1]第四军医大学预防医学系流行病学教研室,陕西西安710033 [2]西安医科大学流行病学教研室,陕西西安710061 [3]中国医学科学院,中国协和医科大学流行病学教研室,北京100005 [4]第四军医大学流行病学教研室

出　　处：《第四军医大学学报》2000年第1期30-33,共4页Journal of the Fourth Military Medical University

摘　　要：目的　从现场流行病学和实验研究两方面探讨乙肝疫苗接种无、弱应答是否与遗传因素有关 .方法　健康小学生 6 34名接种 3针血源性乙肝疫苗 ,共筛选出 2 9名无、弱应答者 ,同时选择 30名强应答者作为对照 .对无、弱应答者和强应答者一级亲属 (同胞和父母 )中符合疫苗接种条件的对象接种 3针乙肝疫苗 ,观察免疫反应 .另外 ,从无、弱应答和强应答者中选择部分对象检测人类白细胞抗原 (HL A ) - A,B,C,DR,DQ座位等位基因 .结果　小学生无、弱应答率为 4.6 %(2 9/ 6 34 ) .无、弱应答者和强应答者一级亲属接种 3针乙肝疫苗后 ,无、弱应答发生率分别为 2 5 .0 %和 1 0 .0 % .无、弱应答者 HL A- DR7和 B5 4频率分别为 5 2 .2 %和 2 1 .7% ,明显高于强应答组 9.1 %和 0 .扩展 HL A单体型频率在无、弱应答者中为 1 7.0 % ,而在强应答者中为 0 .结论　对乙肝疫苗无、弱应答与遗传因素有关 .AIM To evaluate if genetic factor is related to the development of non and hypo response to hepatitis B vaccine by field epidemiology and experimental study. METHODS 634 healthy primary school students were vaccinated with 3 doses of plasma derived hepatitis B vaccine. 29 non and hypo responders were screened and 30 hyper responders were selected as controls. The first degree relatives (siblings and parents) of non and hypo responders and hyper responders who met the requirements of inoculation were immunized with 3 doses of hepatitis B vaccine and followed up. Furthermore, some non or hypo responders and hyper responders were tested alleles of HLA A, B, C, DR, DQ locus. RESULTS The non and hypo response rate in the immunized primary school students was 4.6% (29/634). After the immunization of hepatitis B vaccine, the frequency of non and hypo response in the first degree relatives of non and hypo responders was 25.0% and only 10.0% in hyper responders. The phenotype frequency of HLA DR7 and B54 in non and hypo responders was 52.2% and 21.7%, higher than 9.1% and 0 in hyper responders. The frequency of extended haplotype B54 DR7 was 17.0% in non and hypo responders, but 0 in hyper responders. CONCLUSION Genetic factor is associated with non and hypo response to hepatitis B vaccine.

关 键 词：乙型肝炎 疫苗 接种 免疫应答 HLA抗原 

分 类 号：R512.620.3[医药卫生—内科学]