HBsAg阳性母亲所生新生儿乙肝疫苗和HBIG联合免疫后的抗体持久性观察  

The antibody persistence after immunisation with hepatitis B vaccine combined with different doses of hepatitis B immunoglobulin among infants born by HBsAg positive mothers:a three-year following-up study

作　　者：徐兰英[1] 刘建勋[1] 常战军[1] 李杰[2] 刘亚林[2] 庄辉[2] 程桂芝 魏红霞 陈炜卿 王莉敏[6] 胡志敏 

机构地区：[1]郑州市疾病预防控制中心,河南郑州450007 [2]北京大学医学部,北京100088 [3]新密市妇幼保健院,河南新密452370 [4]巩义市妇幼保健院,河南巩义451200 [5]中牟县妇幼保健院,河南中牟451450 [6]郑州市妇幼保健院,河南郑州450012 [7]郑州市金水区总医院,河南郑州450003

出　　处：《现代预防医学》2017年第7期1205-1207,共3页Modern Preventive Medicine

基　　金：国家科技重大专项资助(2008ZX10002-001;2012ZX10002-001)

摘　　要：目的观察乙肝表面抗原(HBsAg)阳性孕妇所生新生儿采取重组酵母乙型肝炎疫苗(10μg,0-1-6三针)联合乙肝免疫球蛋白(HBIG,100IU或200IU)免疫后3年内的抗体持久性,为制定科学强化免疫策略提供依据。方法新生儿7月龄时及1岁、2岁和3岁时分别采血,追踪观察按照免疫程序免疫后3年内儿童的抗-HBs动态变化情况及持久性。结果儿童的抗-HBs无应答、低应答、正常应答和高应答率分别由7个月时的0.76%、5.34%、38.17%、53.18%(有2.54%感染HBV),变为3岁时的25.13%、44.67%、18.73%和7.68%(有3.79%感染HBV),差异有统计学意义(P<0.001)。3岁时低应答和累计无应答率达到69.80%。抗-HBs几何平均滴度由7个月时的997.56mIU/ml降为3岁时的59.06mIU/ml。7个月时为低应答、正常应答和高应答的,各有一例在3岁前感染。结论母亲HBsAg阳性的,需定期检测抗-HBs,免疫后1-2年加强免疫。Objective To provide a scientific basis for making booster immunization strategy and explore the antibody persistence of immunization with hepatitis B vaccine （YDV, lOp, g, at the age of 0,1, and 6 months ） combined with different doses of hepatitis B immunoglobulin （100IU or 200IU） in 3 years among infants born by hepatitis B surface antigen positive mothers. Methods To observe the dynamic change and persistence of antibody among infants, titers of the antibody against hepatitis B surface antigen （anti - HBs） were detected respectively among children at the age of 7 months, 1,2 and 3 years after the primary vaccination. Results Children＇s no,low,normal and high antibody response rates were O. 76% ,5.34% ,38.17% , 53.18% （2.54% infected with HBV） by 7 months,which changed to 25. 13% ,44.67%, 18.73% and 7.68% （3.79% infected with HBV） respectively by 3 years old, the difference was statistically significant （ P 〈 0. 001 ）. The rate of low and cumulative no antibody response rate was 69.80% at the age of 3 years. The GMC of anti - HBs dropped to 59.06m IU/ml by three years old from 997.56mIU/ml at the age of seven months （ P 〈 O. 001 ） in the following - up periods. There were three new HBV infections by three years old among the children （3/429） ,with low, normal or high antibody response to hepatitis B primary vaccination respectively at the age of 7 months. Conclusion The study results suggest that serological markers of HBV should be tested on a regular basis among children born by hepatitis B surface antigen positive mothers, and after 1 or 2 years, immunity should be strengthened with supplementary HBV vaccination.

关 键 词：YDV[乙型肝炎疫苗(酵母)] 乙肝免疫球蛋白(HBIG) 抗体持久性 新生儿 

分 类 号：R17[医药卫生—妇幼卫生保健]