甲型肝炎减毒活疫苗暴露后预防效果的观察  

Effectiveness of post-exposure prophylaxis using live attenuated hepatitis A vaccine (H_2 strain) among schoolchildren

作　　者：汪萱怡[1] 马景臣 徐志一[3] 刘洪斌 张英林 韩常全 张玉伟 邢占春 陈吉朝 孟宗达 顾惠心[3] 

机构地区：[1]复旦大学医学院分子病毒学实验室,上海200032 [2]河北省正定县卫生防疫站 [3]复旦大学公共卫生学院流行病学教研室 [4]河北省卫生防疫站

出　　处：《中华医学杂志》2002年第14期955-957,共3页National Medical Journal of China

基　　金：国家"九五"攻关课题 (9690 60 3 0 1)

摘　　要：目的　观察国产甲型肝炎 (甲肝 )减毒活疫苗暴露后预防效果。方法　在河北正定某自然村甲型肝炎流行开始时 ,对该村小学所有学生采集血清 ,检测甲肝易感性 ,并给予接种一剂甲肝减毒活疫苗 [H2 株 ,滴度为 10 6 6 7组织培养半数感染量 (TCID50 ) ]。接种后 18天 (最短潜伏期 )与最后 1例甲肝病例发生后 4 0天 (最长潜伏期 )两次采集两组观察对象血清 ,观察两组感染与发病情况。结果　在接种后 18天以内及 18天至最后一病例发生后 4 0天 (流行结束 )两个观察期内 ,接种组与非接种组新感染率与罹患率均差异无显著意义 (P >0 0 5 )。结论　在本次流行中 ,未能发现甲型肝炎减毒活疫苗用于暴露后预防的效果 。Objective To observe the efficacy of emergency immunization to abort hepatitis A outbreak using live attenuated hepatitis A vaccine. Methods During an outbreak of hepatitis A in a village in Zhengding County, Hebei Province, one dose of live attenuated hepatitis A vaccine (H 2 strain) was administered to 92 schoolchildren of two primary schools in that village on a voluntary basis, and 189 schoolchildren who were not vaccinated were used as controls Their serum specimens were collected 3 times at different time points (0 and 18 days after the vaccination and 40 days after the appearance of the last hepatitis A case) The total antibody and IgM of hepatitis A were examined by ELISA Clinical observation was made to discover whether new case appeared The rates of seroconversion and hepaititis A in susceptibles between vaccinated and unvaccinted groups were compared Results The new infection rate of hepatitis A during the 18 days after vaccination was 5 43% in the vaccinated group and 7 43% in the control group ( P > 0 05) The prevalence rate was 0 in both groups ( P > 0 05) The new infection rate of hepatitis A during the period from the 18th day after vaccination to the 40th day after the appearance of the last case was 2 41% in the vaccinated group and 3 21% in the control group ( P > 0 05) Conclusion The live attenuated hepatitis A vaccine can not provide post exposure protection against infection of hepatitis A virus during the outbreak

关 键 词：甲型肝炎 病毒疫苗 暴露后预防 

分 类 号：R186[医药卫生—流行病学]