新生儿接种乙肝疫苗后无(弱)应答情况及其影响因素研究  

Newborns' non-and-low response and its influential factors after being vaccinated with hepatitis B vaccine

作　　者：徐志伟[1] 伍成奇[1] 楚亦文[1] 刘艳[1] 冯玉萍[1] 

机构地区：[1]河南省人民医院疾病预防控制科,河南郑州450003

出　　处：《现代预防医学》2016年第21期4015-4018,4023,共5页Modern Preventive Medicine

摘　　要：目的了解新生儿接种乙肝疫苗后的无(弱)应答情况,对其影响因素进行分析。方法选取2014年1月至2015年6月期间在河南省人民医院门诊接种乙肝疫苗的634例新生儿,均在接种第三剂次接种完成后的第42天采集静脉血2ml,分离血清,采用时间分辨免疫荧光法定量检测抗-HBs。设计统一调查表,固定经过培训的专门人员对新生儿监护人进行预防接种相关情况的调查。结果新生儿接种乙肝疫苗后无(弱)应答率为8.04%,影响新生乙肝疫苗免疫效果的因素有新生儿地区来源(OR=1.664,P=0.047)、母亲HBsAg(OR=1.054,P=0.001)、父亲HBsAg(OR=2.085,P=0.012)、母亲接种乙肝无(弱)应答史(OR=5.316,P<0.001)、父亲接种乙肝无(弱)应答史(OR=7.710,P<0.001)、按0、1、6免疫程序接种(OR=0.243,P=0.016)、母乳喂养(OR=0.194,P<0.001)。结论按规定时间接种疫苗、母乳喂养、控制HBsAg阳性的父亲或母亲血清HBV DNA含量对提高新生儿接种乙肝疫苗应答率,进而更有效的控制乙肝病毒感染,具有十分重要的现实意义。Objective To understand newborns＇ non - and - low response after being vaccinated hepatitis B vaccine,to analyze its influential factors. Methods 634 newborns （born during January 2014 and June 2015 ） were selected and they were vaccinated with hepatitis B vaccine in the out - patient department of Henan people＇s hospital. Venous blood （2ml） was collected on the 42nd day after the third dose. And the serum was separated. Time - resolved immunofluorescence method was used to test anti - HBS quantitatively. The questionnaire was designed uniformly and specially trained personnel was fixed to investigate the newborns＇ guardian about the state of preventative vaccination. Results After being vaccinated with hepatitis B vaccination,the non- and- low response rate was 8.04%. Factors influencing immune effect of hepatitis B vaccine were the region （ OR = 1. 664,P = 0. 047）, the mother＇s HBsAg （ OR = 1. 054, P = 0. 001 ）, the father＇s HBsAg （ OR = 2. 085, P = 0. 012） ,the non - and - low response rate history of his mother （ OR = 5.316,P 〈0. 001 ） and father （ OR = 7.7 10, P 〈 0. 001 ） after being vaccinated hepatitis B vaccine, the zero - one - six vaccination procedure （OR = 0. 243, P = 0. 016） and breastfeeding （ OR = 0. 194, P 〈 0. 001 ）. Conclusion Newborns＇ response rate can be improved by the ways of reeeiving vaccination aceording to the prescriptive time,breastfeeding,controlling the DNA quantity of HBsAg in their father＇s or mother＇ s body,whose HBsAg is positive. Furthermore, the infection rate of hepatitis B virus can be effectively controlled, whieh has signifieant practieal meaning.

关 键 词：新生儿 乙肝疫苗 无(弱)应答 影响因素 

分 类 号：R186[医药卫生—流行病学]