慢性肾脏病患者接种乙肝疫苗疗效研究  

Chronic Kidney Diseaes Hepatitis B Vaccine Efficacy

作　　者：王福珍[1] 吴森超[1] 丘昭文[1] 许春梅[1] 郭春花[1] 林文静[1] 林冲云[1] 朱杰[2] 王朝晖[3] 

机构地区：[1]福建医科大学附属龙岩市第一医院肾内科,龙岩364000 [2]上海师范大学数理学院,上海200234 [3]上海交通大学医学院附属瑞金医院肾内科,上海200025

出　　处：《中国中西医结合肾病杂志》2015年第5期418-421,共4页Chinese Journal of Integrated Traditional and Western Nephrology

基　　金：国家自然科学基金资助项目(No.81170634);福建医科大学附属龙岩市第一医院优秀青年医师科研项目(No.0010)

摘　　要：目的：探讨慢性肾脏病（chronic kidney disease,CKD）早中期（CKD1～3期）、晚期（CKD4～5期）患者接种乙肝疫苗后的反应情况,明确CKD患者接种乙肝疫苗的最佳时期,使CKD患者产生主动免疫抵御HBV感染。方法：对乙肝两对半全阴性的慢性肾脏病早中期、晚期患者接种乙肝疫苗,观察两组患者乙肝表面抗体的阳转率及抗体滴度高低情况,同时,将CKD早中期组分为接受或未接受激素/免疫抑制剂两组,所有CKD患者再分为男性、女性两组,分别对上述分组进行比较,观察各组患者乙肝表面抗体的阳转率及抗体滴度高低情况。结果：（1）CKD早中期患者接种乙肝疫苗后,乙肝表面抗体阳转率明显高于CKD晚期患者,且抗体滴度明显高于CKD晚期组。（2）在CKD早中期组中接受或未接受激素/免疫抑制剂治疗的患者中抗体阳转率差异无统计学意义,但接受激素/免疫抑制剂组抗体滴度更高。（3）性别不是影响乙肝疫苗接种效果的因素。结论：CKD早中期患者接种乙肝疫苗疗效优于CKD晚期患者,激素及免疫抑制剂治疗不影响CKD早中期患者接种乙肝疫苗的疗效,性别不影响接种效果。Objective： To compare the response rate to HB vaccine in CKD stage 1 ～ 3 patients with that in CKD stage 4 ～ 5and clear the best period of hepatitis B vaccination for patients with CKD,which help to produce active immunization against hepatitis B virus infection for patients with CKD. Methods： Patients with group CKD（ 1 ～ 3）,and group CKD（ 4 ～ 5） were all vaccinated against hepatitis B virus infection. Then the antibody of hepatitis B was detected. At the same time,CKD（ 1 ～ 3） patients were divided into two groups： Group- A： to accept hormone / immunosuppressants,Group- B： not to accept. All participants with CKD were divided into two groups： male and female. After completion of the vaccination schedule,seroconversion and seroprotection rates in each group were investigated. Results：（ 1） The seroconversion rate of patients with CKD（ 1 ～ 3） was significantly higher than that of patients with CKD（ 4 ～ 5）,and the degree of HBV- Ab was significantly higher than that of patients with CKD（ 4 ～ 5）.（ 2） There was no difference of the positive rate of HBV- Ab and the degree of HBV- Ab between the two groups who accepted or didn＇t accept hormone / immunosuppressants.（ 3） There was no significant difference of the effect of hepatitis B vaccination between males and females. Conclusion： CKD（ 1 ～ 3） patients showed higher response rate than patients with CKD（ 4 ～ 5）. Hormone and immunosuppressants treatment did not affect the effect of hepatitis B vaccination of patients with CKD 1 ～ 3,and gender was not associated with seroconversion.

关 键 词：慢性肾脏病 乙肝疫苗 抗体阳转率 

分 类 号：R186[医药卫生—流行病学]