新生儿乙肝疫苗免疫后15年效果观察  

Observational Study on Immunization Effectiveness of Hepatitis B Vaccine in Newborn Babies During 15 Years

作　　者：王继杰 颜天强 罗述斌 李乔生 李述智 曹惠霖 刘崇柏 夏国良 

机构地区：[1]湖南省湘潭市卫生防疫站,湘潭411100 [2]湖南省卫生防疫站,长沙410005 [3]湘潭钢铁厂防疫站 [4]湖南省湘潭市卫生局 [5]中国预防医学院病毒学研究所,北京100052

出　　处：《实用预防医学》2000年第6期419-421,共3页Practical Preventive Medicine

基　　金：国家九.五攻关课题! (编号 96- 90 6- 0 3- 0 2 )

摘　　要：[目的 ]　了解新生儿乙肝疫苗免疫后抗 - HBs消长动态及远期保护效果。 [方法 ]　从 1986年开始 ,每隔 1～ 2年 ,采取整群随机方法对湘潭市区 1985～ 1988年出生的新生儿接种乙肝疫苗后的效果随访一次 ,采血检测HBs Ag、抗 - HBs和抗 - HBc。 [结果 ]　 15年共观察儿童 5 0 0 6名 ,各次观察的 HBs Ag携带率为 0 .6 3%～ 2 .32 % ,平均携带率为 1.38%。明显低于免疫前同一人群的 10 .33% ,保护率为 86 .6 5 % (95 %可信区间为 72 .13%～ 10 0 .0 0 % )。全程免疫后抗 - HBs的阳性率及几何平均滴度 (G)高峰值均出现在首针接种后 7～ 12个月 ,此后随着时间的推移而逐渐下降 ,但免疫后 15年的儿童中仍有 45 .31%的个体抗 - HBs的 m Iu/ml值 >10 .0 ,G值为 2 7.95 m Iu/ml,且HBs Ag和抗 - HBc阳转率没有明显变化。 [结论 ]　乙肝疫苗具有持久的保护效果 ,而且抗 - HBs阳转率的下降并没有导致 HBs Ag感染率的上升 ,说明在选择加强免疫的时间方面 ,抗 - HBs仅仅只能作为一个间接指标。Objective] In order to investigate the anti-HBs transformation tendeney and the long-term protective effect in children who has been immunized with hepatitis B vaccine at birth.[Methods] Since 1986, the 5006 children who were immunized with hepatitis B vaccine at birth and follow up at least once in each 1～2 year. Serum HBsAg、 anti-HBs and anti-HBc were tested.[Result] The results of all examinationes showed that HBsAg positive rate in the vaccine group were 0 63%～2 32% during 15 years. The HBsAg average positive rate was 1 38% and that was much lower than 10.33% of same age population of background survey. The protective rate was 86.65%(95% confidence interval:72.13%～100.00%). The highest peak of the anti-HBs positive rate and the geometric mean titres (G) both appeared in 7 th ～12 th month and then gradually decreased with the lapse of time. But the anti-HBs positive rate of 15 years old children was 45.31% and GMT was 27.95 mIu/ml. The HBaAg positive rate and the anti-HBc positive rate were not changed.[Conclusion] The efficacy of hepatitis B vaccine was long-term. The decrease of anti-HBs positive rate did not lead to increase of HBsAg positive rate. The results indicated that anti-HBs was a indirect indicator only, at time of booster dose was selected.

关 键 词：新生儿 乙肝血源疫苗 远期效果 

分 类 号：R722.13[医药卫生—儿科] R186[医药卫生—临床医学]