乙肝疫苗不同剂量加强免疫的效果观察  

An observation on effect of different dosage booster immunization of hepatitis B vaccine

作　　者：刘灿磊[1] 姚军[2] 苏美芳[1] 陈永弟[2] 施海云[1] 尹银香 尚建斌 陈丹[1] 

机构地区：[1]玉环县疾病预防控制中心,浙江玉环317600 [2]浙江省疾病预防控制中心

出　　处：《浙江预防医学》2014年第11期1081-1084,共4页Zhejiang Journal of Preventive Medicine

基　　金：国家十一五艾滋病和病毒性肝炎等重大传染病防治项目(2009ZX10004-901)

摘　　要：目的：评价儿童乙肝疫苗不同剂量加强免疫1剂后的免疫效果，为实施乙肝疫苗加强免疫提供依据。方法选择玉环县户籍5～11岁且1岁内完成乙肝疫苗基础免疫但未加强免疫的儿童，分别采用含5μg甲乙肝联合疫苗547人和10μg乙肝疫苗688人加强免疫1剂，在加强免疫前、后1个月分别检测乙型肝炎表面抗体（抗－HBs）浓度水平。结果加强免疫1个月后，使用含5μg和10μg两组儿童抗－HBs阳性率分别为97.81％和96.08％，抗－HBsGMT分别为1433.18和2111.43mIU/mL。加强免疫前抗－HBs阴性儿童抗－HBs阳转率分别为94.78％和93.62％；年龄越小，免疫阳转率越高（P＜0.05）。加强免疫前后，两种不同剂量疫苗在抗－HBs阳性率和抗－HBsGMT的差异均有统计学意义（P＜0.01）；抗－HBsGMT差值均数10μg乙肝疫苗高于含5μg甲乙肝联合疫苗（P＜0.05）。多因素分析提示，5岁以上儿童加强免疫，年龄越小其阳转率越高（OR＝0.698，95％CI为0.602～0.808）。结论5～11岁儿童加强乙肝免疫无论剂量大小均有较好的效果，年龄越小其免疫反应越好；10μg乙肝疫苗加强后的抗－HBsGMT高于含5μg甲乙肝联合疫苗。Objective To evaluate the effect on the booster immunization of different dosage of hepatitis B vaccine among children and to provide suggestions for booster immunization.Methods Children aged 5 -1 4 years old were randomly selected who had received the primary immunization of hepatitis B vaccine under 1 year old but had not received the booster immunization in Yuhuan county.A total of 547 children received 5 μg hepatitis A and B combined vaccine boost immunization and 688 children received 1 0 μg hepatitis B vaccine boost immunization in 2009.The anti -HBs levels before and after the boost immunization were detected.Results The anti -HBs positive rates of children received 5 μg and 1 0 μg vaccine boost immunization were 97.81 % and 96.08% respectively and the positive rates in the antibody negative children were 94.78% and 93.62% respectively.While the Geometric Mean Titer （GMT） of anti -HBs were 1 433.1 8 mIU /mL and 21 1 1 .43 mIU /mL respectively,which were both significantly higher than those before the boost immunization （P 〈0.001 ）.The increase of GMT of children received 1 0 μg hepatitis B vaccine was significantly higher than that of children received 5 μg hepatitis A and B combined vaccine （P 〈0.05）.Conclusion Both dosages of hepatitis B vaccine booster immunization are effective for children aged 5 -1 4 years old and 1 0 μg hepatitis B vaccine boost immunization has the better effect.

关 键 词：乙肝疫苗 甲乙肝联合疫苗 加强免疫 免疫效果 

分 类 号：R186[医药卫生—流行病学]