淮安市淮安区新生儿乙肝疫苗计划免疫策略实施效果的监测评价  

Surveillance and evaluation of expanded programmed immunization of Hepatitis B Vaccine in newborns in Huaian district,Huaian City,Jiangsu province

作　　者：张旭 张秋明 刘耀珍 陈建琳 李贇 朱立国[2] 朱凤才[2] 翟祥军[2] 

机构地区：[1]淮安市淮安区疾病预防控制中心,江苏淮安223200 [2]江苏省疾病预防控制中心.江苏南京210009

出　　处：《南京医科大学学报（自然科学版）》2014年第12期1779-1782,共4页Journal of Nanjing Medical University(Natural Sciences)

基　　金：国家科技重大专项(2008ZX10002-001)

摘　　要：目的 ：评价近期淮安市淮安区新生儿乙肝疫苗计划免疫策略实施效果及其影响因素。方法 ：采用血清流行病学调查方法,调查7-12月龄幼儿的乙肝疫苗接种史,检测HBs Ag、抗-HBs和抗-HBs。对新生儿的乙肝疫苗免疫效果及其影响因素进行分析评价。结果：共对2 320名幼儿开展了调查。乙肝疫苗计划免疫及时接种率高达99.6%,均全程接种了疫苗。监测对象的HBs Ag阳性率0.13%,核心抗体阳性率为2.1%,估计乙肝疫苗保护率在93.4%,母婴阻断成功率为91.6%,幼儿HBs Ag阳性的原因为母婴阻断失败,所有母婴阻断失败幼儿的母亲为HBe Ag阳性感染者。接种5 g苗的幼儿抗体低、无应答率为26.3%,高于计划免疫中接种10 g疫苗的地区。出生低体重幼儿的低、无应答率高于出生正常体重幼儿。结论 ：目前乙肝疫苗计划免疫的规范接种率高,幼儿HBV慢性感染率低,幼儿的慢性HBV感染主要归因于母婴阻断失败。应提高乙肝疫苗计免免疫中的接种剂量。Objective：To survey and evaluate the effects of expanded programmed immunization of hepatitis B vaccine in newborns. Methods：A sero-epidemiology surveillance was conducted in infants aged 7-12 months in Huaian district of Huaian.Immunization history of hepatitis B vaccine（Hep B）was investigated and blood samples were collected at the same time. HBs Ag,antiHBs and anti-HBc was detected using chemiluminescence microparticle imunoassay（CMIA）. HBs Ag seropositive rate,anti-HBc seropositive rate,seroconversion rate and titer of anti-HBs were calculated and the influenced factors were analyzed using χ2test or analysis of variance（ANOVA）. Results：Twenty-three hundred and twenty infants were involved in the investigation. The timely first dose injection rate was 99.6%,and all the infants received the whole course vaccination. The HBs Ag and anti-HBc seropositive rate was 0.13% and 2.1%,respectively the calculated protective rate of the Hep B was 93.4% and succession rate of blocking the maternal-infant transmission was 91.6%. The cause of the chronic HBV infection in the immunized infants was the failure of blocking maternal-infant transmission,the failure all happened in the infants with HBe Ag positive mothers. The non-hyporesponsive rate was26.3% in our surveillance population who immunized with 5 g Hep B,which was higher than other places using 10 g Hep B as the newborn immunization vaccine. Meanwhile the low birth weight infants had higher non-hyporesponsive rate than the normal birth weight infants. Conclusion：The standard vaccination rate of Hep B was very high and chronic HBV infection was very low in infants now. The chronic HBV infection in infants was mainly caused by maternal-infant transmission. The vaccine dose used in the infants should be added.

关 键 词：乙肝病毒 乙肝疫苗 计划免疫 监测 母婴传播 

分 类 号：R512.62[医药卫生—内科学]