成人乙型肝炎疫苗无应答者大剂量再免疫效果评价  

Effect evaluation on non-response adults after revaccinated with megadose hepatitis B vaccine

作　　者：宋红潮[1] 熊传庆 郭艳秋[1] 梁绍莲[1] 朱丹[1] 黄泽强[1] 

机构地区：[1]广西医科大学第一附属医院预防保健科,广西南宁530021

出　　处：《现代预防医学》2015年第20期3783-3785,共3页Modern Preventive Medicine

基　　金：广西壮族自治区卫生厅公共卫生计划课题(Z2012114)

摘　　要：目的探讨2种大剂量乙型肝炎(乙肝)疫苗对无应答成人再免疫的效果,为60μg/1.0 ml乙肝疫苗的临床应用提供依据。方法将有乙肝疫苗全程接种史、乙肝表面抗原(HBs A)g及乙肝表面抗体(抗-HBs)阴性的健康成人,根据知情同意、随机原则分为2组,1组为20μg组,即接种3针20μg乙肝疫苗,按"0、1、6"程序;1组为60μg组,即接种1针60μg乙肝疫苗。完成免疫程序后3个月内检测乙肝5项指标。结果无应答成人再免疫后,20μg组和60μg组2组抗-HBs阳转率约为88%,且正常应答者,2组抗-HBs几何平均滴度(GMT)水平相近,差异无统计学意义(P>0.05),低应答者,60μg组抗-HBs GMT高于20μg组(P<0.05)。男性抗-HBs阳转率较女性低(P<0.05),不同年龄组间抗-HBs阳转率差异无统计学意义(P>0.05)。结论 1针60μg/1.0 ml乙肝疫苗和3针20μg/ml乙肝疫苗疗效相当,可根据个体实际情况选择免疫方案。Objective This work was to investigate the effects of the revaccination with megadosage of hepatitis B vaccine on non-response adults, and to provide the basis for the clinical application of 60μg/1.0ml of hepatitis B vaccine. Methods According to the principle of informed consent and random grouping, the healthy adults negative both for hepatitis B surface antigen and hepatitis B surface antibody were randomly divided into two groups. One group were inoculated with 20 μg hepatitis B vaccine according to the schedule of 0, 1 and 6 month. The other group received one dose of 60μg hepatitis B vaccine. The five indexes of hepatitis B were tested within 3 months after revaccinated. Results After revaccination, the anti-HB positive rate of the 20 μg group and 60 μg group were all about 88%. Among those with positive conversion, the level of anti-HBs Geometric Mean Titer（GMT） of two groups were similar and there was no statistically significant difference（P〉0.05）. Among those with low level respondence, the level of anti-HB GMT of the 60 μg group was higher than that of the 20 μg group（P〈0.05）. Anti-HB positive rate of males was lower than that of females（P〈0.05）. Anti-HB positive rate of different age groups had no statistically significant difference（P〉0.05）.Conclusion The efficacy of one dose hepatitis B vaccine of 60 μg/ml and three doses of 20 μg/ml vaccine was equivalent. Immune scheme was should be chosen according to individual＇s personal situation.

关 键 词：乙肝疫苗 无应答 再免疫 大剂量 

分 类 号：R186[医药卫生—流行病学]