大学新生乙肝疫苗免疫效果及影响因素  

Analysis on efficacy of hepatitis B vaccination and factors impacting on response in the college freshers

作　　者：熊咏珍[1] 林伟研[2] 陈如红[1] 董文亚[2] 黎美宝[2] 倪进东[2] 

机构地区：[1]广东医学院校医务室,广东东莞523808 [2]广东医学院公共卫生学院,广东东莞523808

出　　处：《中华疾病控制杂志》2013年第6期517-519,共3页Chinese Journal of Disease Control & Prevention

基　　金：广东省自然科学基金(s2011040002978);广东省医学科学技术研究基金(A2012422);东莞市科技计划项目(201010815214)

摘　　要：目的了解年轻成人乙肝疫苗接种效果及影响因素。方法在1 481名完成乙肝疫苗全程接种的年轻成人中,比较不同性别、体重指数(body mass index,BMI)分级间乙肝疫苗应答率和抗表面抗原(抗-HBS)抗体水平差异;根据无应答者性别、年龄和BMI匹配,选择正常对照,比较两组间Th细胞因子差异。34名无应答自愿者,加强接种1剂次60μg乙肝疫苗,检测其免疫后抗体阳转情况。结果乙肝免疫接种后有1 404人(抗-HBs)抗体阳性,抗体阳转率为94.80%。女性抗体阳转率及抗体滴度水平均高于男性,差异有统计学意义(均有P<0.05),无应答者血清INF-γ和IL-4水平分别为18.97(IQR:15.18,27.67)和22.01(IQR:11.96,41.51)均高于对照组(Z=2.268,P=0.023)。无应答者加强接种后抗体阳转率为35.29%。结论男性性别是发生乙肝疫苗无应答危险因素,Th1/Th2两类细胞因子分泌不足与乙肝疫苗无应答发生相关。Objective To investigate efficacy of hepatitis B vaccination and factors impacting on response in the college freshers.Methods In this study,1 481 young adults who received hepatitis B vaccination were divided into nonresponders group and controls by anti-HBs antibody levels.The protective rate of antibody and antibody level were analyzed according to gender and BMI.Besides,serum level of Th1 / Th2 cytokines were examined in responders（N = 77） and nonresponders（N = 77）.Meanwhile the students with anti-HBs level below 10mlU / ml took the booster immunization and the result was monitored.Results There were 1 404 participants positive for anti-HBs（≥10 mIU / mL） and the positive rate of anti-HBs was 94.80%.There was significant difference in protective rate and antibody level between male and female.The serum INF-γ and IL-4 levels of the non-responder group were 18.97（IQR： 15.18,27.67） and 22.01（IQR： 11.96,41.51）,respectively,and both were significantly lower than the corresponding values of the control group（Z = 2.268,P = 0.023）.The protective rate was 35.29% after re-vaccine with one dose 60 μg HBV vaccine in non-responders.Conclusions Male gender are related to poor immune response to HBV vaccine.Inadequate Th1 and Th2 cytokine production may be attribute to non-responseness to HBV vaccine.

关 键 词：肝炎疫苗 乙型 免疫接种 加强 危险因素 

分 类 号：R512.62[医药卫生—内科学] R186.7[医药卫生—临床医学]