母亲血清抗-HBs阳性对其新生儿接种乙肝疫苗接种效果的影响研究  

Impact of maternal serum anti-hepatitis B surface antibody on their newborn response to hepatitis B vaccination

作　　者：陈奋 林道炯[2] Chen Fen;Lin Daojiong(Department of Paediatrics,Maternal and Child Health Care Hospital,Wenchang 571300,Hainan Province,China)

机构地区：[1]海南省文昌市庆龄妇幼保健院儿科,571300 [2]海南省人民医院儿科

出　　处：《实用肝脏病杂志》2018年第4期557-560,共4页Journal of Practical Hepatology

摘　　要：目的探讨母亲血清抗-HBs阳性对其新生儿接种乙肝疫苗应答效果的影响。方法 2012年6月~2013年6月在我院产科住院待产的60名单胎妊娠妇女,31名母亲血清抗-HBs阳性,29名母亲血清抗-HBs阴性。对所有新生儿在出生24 h、1 m和6 m接种乙肝疫苗,随访3年,观察两组新生儿血清抗-HBs应答效果。结果两组新生儿接种乙肝疫苗1年后,母亲血清抗-HBs阳性组幼儿对接种疫苗无应答率为12.9%,低应答率为22.6%,正常应答率为29.0%和高应答率为35.5%,与母亲血清抗-HBs阴性组的10.3%、20.7%、37.9%和31.0%比,无显著性差异(P>0.05);3年后,母亲血清抗-HBs阳性组幼儿血清抗-HBs阳性率为87.1%,与血清抗-HBs阴性组的89.7%比,无显著性差异(P>0.05);母亲血清抗-HBs阳性组与阴性组幼儿血清抗-HBs水平分别为74.3(6.3~854.0)m IU/ml和73.6(3.4~950.6)m IU/ml,两组差异无统计学意义(P>0.05),但均明显低于1年时各自的水平[分别为1162.1(164.5~3202.3)m IU/ml和1104.2(153.0~2584.7)m IU/ml,P<0.05];在3岁末,60名幼儿血清HBs Ag和抗-HBc均为阴性,对7名血清抗-HBs阴性儿童加强接种后,结果 6个月后,6名幼儿血清抗-HBs转阳。结论按照目前国家推荐的接种计划对新生儿接种乙肝疫苗能够有效地保护其对抗HBV感染,母亲血清抗-HBs阳性可能并不会对新生儿接种乙肝疫苗的免疫应答产生不良影响。Objective To investigate the impact of maternal serum anti-hepatitis B surface antibody(anti-HBs)on their newborn response to hepatitis B vaccination.Method 60 pregnant women(31 with serum anti-HBs positive and 29 negative)and their single newborns were recruited between June 2012 and June 2013 in this study,and the fetuses were vaccinated with hepatitis B vaccine instance,1 month and 6 months after birth.All the fetuses were followed-up for three years.Results At the end of one year followed-up,the nonresponse,lower response,normal response and strong response rates in children with their mother’s serum anti-HBs positive were 12.9%,22.6%,29.0%and 35.5%,without significant differences as compared to 10.3%,20.7%,37.9%and 31.0%(P>0.05)in children with their mother’s serum anti-HBs negative;at the end of 3 year followed-up,serum anti-HBs positive in children with their mother’s serum anti-HBs positive were 87.1%,no significant difference as compared to 89.7%(P>0.05)in children with their mother’s serum anti-HBs negative;serum anti-HBs levels represented by geometric average concentration(GMC)in children with their mother’s serum anti-HBs positive and negative were 74.3(6.3~854.0)mIU/ml and 73.6 mIU/ml(3.4~950.6)mIU/ml,respectively,no significant difference(P>0.05),while they both decreased as compared to serum levels of their own at the end of one year[1162.1(164.5~3202.3)mIU/ml and 1104.2 mIU/ml(153.0~2584.7)mIU/ml,respectively,P<0.05];serum HBsAg and anti-HBc were all negative in the 60 children,and boosting vaccination were completed in seven children with serum anti-HBs negative,and six responded.Conclusion Inoculation of hepatitis B vaccine in newborn infants in accordance with the current national vaccination plan can definitely protect them from hepatitis B viral infectoin.Maternal serum anti-HBs might not obstacle the immune response of their newborns to hepatitis B vaccination.

关 键 词：新生儿 乙肝疫苗 抗-HBS 母亲 

分 类 号：R186[医药卫生—流行病学]