新生儿乙肝疫苗免疫效果及影响因素评价  

Evaluation of immunity effectiveness and related factors of hepatitis B vaccine in new-born infants

作　　者：李波[1] 崔伟红[1] 衣学梅[1] 李书胜[1] 姜梅[1] 

机构地区：[1]烟台市疾病预防控制中心,山东烟台264003

出　　处：《现代预防医学》2013年第3期438-440,共3页Modern Preventive Medicine

基　　金：国家科技重大专项艾滋病和病毒性肝炎等重大传染病防治专项"我国乙型病毒性肝炎免疫预防策略研究子课题二"提高乙肝疫苗免疫应答率的研究"(2008ZX10002-001)

摘　　要：目的评价新生儿乙肝疫苗初免及低/无免疫应答者再免效果,分析影响因素。方法化学发光微粒子免疫分析法(CMIA)检测抗-HBs。结果新生儿首针乙肝疫苗(HepB1)及时接种率97.19%,未种者中早产、低体重儿占53.54%。初免乙肝表面抗体(抗-HBs)保护率80.75%,低、无应答分别占17.56%、1.69%。性别不同、顺产与剖腹产、早产与足月儿应答率差异无统计学意义。县级及以上医院出生、父母乙肝表面抗原(HBsAg)阴性儿童应答率较高。各组抗体几何平均滴度(GMC)差异均无统计学意义。对低/无免疫应答者再免1剂次,有82.71%儿童达到正常应答;再免3剂次,有96.06%儿童达到正常应答。10μg汉逊酵母组GMC高于5μg啤酒酵母组。结论剖腹产、早产儿能产生良好应答。对低/无应答者,再免能取得较高应答,且3剂次效果优于1剂次。需加强孕妇筛查,制订低/无应答儿童补充免疫策略。OBJECTIVE To assess the immunity effectiveness of 5μg/agent vaccine in new-born infant and to evaluate related factors. METHODS Anti-HBs were detected with CMIA. Non-and-low response infants were boosted with 3 doses HepB at 0, 1, 6 months and the immunity effectiveness were re-evaluated. RESULTS 97.19% of children were vaccinated timely. In non-booster children, 53.54% were premature birth and low-weight infants. After the initial immunity, 80.75% had protection response, 17.56% had low response, and 1.69% of infants had no response. Different gender, natural delivery and caesarean section, premature and full-term infants had the same response rate. Infants who were born in different hospitals, whose parents had Negative -HBsAg or positive- HBsAg had different response rates but the same GMC. After one dose immunity, 82.71% children had normal response. After three doses of the vaccine, the response rate reached 96.06%. The GMC of 10μg/agent was higher than that of 5 μg/agent. CONCLUSION Caesarean and premature babies have good response. For low- or no-response groups, re-vacination can reach a higher response rate. After three doses of the vaccine, the response rate reaches at a high level. We should strengthen screening of pregnant women and develop supplementary immunization strategies of low/no response infants.

关 键 词：新生儿 重组HepB 免疫效果 再免 

分 类 号：R186[医药卫生—流行病学]