婴幼儿乙肝疫苗初次免疫及低(无)应答者再次免疫效果分析  

Analysis of revaccination effect of hepatitis B vaccine on infants accepted primary immunization and with low/non immune response

作　　者：刘中芹 王晓琼[1] 王颖[1] 郭昊[1] 刘召红[1] 崔佳[1] 

机构地区：[1]山东省寿光市疾病预防控制中心,山东寿光262700

出　　处：《疾病预防控制通报》2015年第5期7-9,共3页Bulletin of Disease Control & Prevention(China)

基　　金：国家科技重大专项艾滋病和病毒性肝炎等重大传染病防治专项"乙型肝炎病毒免疫预防新策略的研究"中"初免低(无)应答人群随访研究及慢性肝病患者乙肝疫苗接种效果等研究"(2012ZX10002001)

摘　　要：目的评价2009─2014年山东省寿光市婴幼儿乙肝疫苗初次免疫及其低(无)免疫应答者再次免疫效果,为进一步完善婴幼儿乙型肝炎的免疫预防策略提供科学依据。方法对971名已按'0-1-6'程序接种5μg重组乙肝疫苗(啤酒酵母)的7~12月龄的婴幼儿进行筛选,检测乙肝表面抗体滴度(抗-HBs),对其中低(无)免疫应答者,分别用5μg重组乙肝疫苗(啤酒酵母)和10μg重组乙肝疫苗(汉逊酵母)再全程免疫3剂次。结果婴幼儿的初次免疫抗-HBs保护应答率为81.36%,无(低)应答分别占1.44%和17.20%;对低(无)应答者再次免疫1剂次和3剂次,保护应答率分别为83.33%和92.03%,差异有统计学意义(χ2=4.830,P<0.05);抗体几何平均滴度(GMT)分别为1 544.30 IU/L和1 308.78 IU/L(t=0.932,P>0.05);10μg重组乙肝疫苗(χ2=1.148)与5μg重组乙肝疫苗(χ2=3.456)再免疫1剂次和3剂次,保护应答率差异无统计学意义(P>0.05);GMT差异有统计学意义(t=-2.645,t=-3.197,均P<0.05)。结论 5μg重组乙肝疫苗(啤酒酵母)和10μg重组乙肝疫苗(汉逊酵母)再次免疫都能取得较好应答,且3剂次效果优于1剂次,10μg重组乙肝疫苗优于5μg重组乙肝疫苗。Objective To evaluate revaccination effect of hepatitis B vaccine on infants accepted primary immunization and with low/non immune response, in order to provide basis for improving immune strategies of hepatitis B immune in infants. Methods Nine hundred and seventy-one infants(7-12 month-old) vaccinated with 5μg r HB vaccine(Saccharomyces cerevisiae, S.c) following'0-1-6'immunization schedule were chosen to test anti-HBs titer. The infants with low/non immune response were revaccinated with 3 doses of 5 μg r HB vaccine(S.c) or 10 μg r HB vaccine(H.p). Results Immune response rate after primary immunization was 81.36%, with the low immune response rate of 1.44% and non-immune response rate of 17.20%. The immune response rates of the infants with low/non immune response after 1 dose and 3 doses revaccination were 83.33% and 92.03%, respectively(χ2=4.830, P<0.05), while GMT were 1 544.30 IU/L and 1 308.78 IU/L,respectively(t=0.932, P>0.05). There was no significant difference(P>0.05) in the immune response rates between infants revaccinated with 1 dose and 3 doses of 10 μg r HB vaccine(H.p, χ2=1.148) and 5 μg r HB vaccine(S.c, χ2=3.456), while the difference in GMTs between them was significant(t=-2.645, t=-3.197, P<0.05). Conclusions Revaccination with 5 μg r HB vaccine(S.c) and 10 μg r HB vaccine(H.p), both can obtain higher response, and three doses(times) is prior to one dose(time), and 10μg r HB vaccine(H.p) prior to 5μg r HB vaccine(S.c).

关 键 词：婴幼儿 乙肝疫苗 免疫效果 再次免疫 

分 类 号：R186[医药卫生—流行病学]