儿童维生素D营养状况与乙肝疫苗免疫反应相关性研究  

Correlation between children’s serum vitamin D and hepatitis B vaccine immune response

作　　者：黄小丽[1] 陈丽锦 赵丽 林闽川 蔡建兴 叶辉铭[1,2] HUANG Xiao-li;CHEN Li-jin;ZHAO Li;LIN Min-chuan;CAI Jian-xing;YE Hui-ming(Department of Medical Laboratory,Women and Children’s Hospital,Xiamen,Fujian 361003,China;不详)

机构地区：[1]厦门大学附属妇女儿童医院,厦门市妇幼保健院医学检验科,福建厦门361003 [2]厦门大学医学院,福建厦门361102

出　　处：《现代预防医学》2020年第17期3140-3143,共4页Modern Preventive Medicine

基　　金：厦门市科技局科技惠民项目(3502Z20174021);厦门市第二批青年创新创业人才项目(2015-A-03)。

摘　　要：目的探讨儿童维生素D营养状况对乙型肝炎疫苗免疫反应的影响。方法选取2016年1月至2018年12月在厦门大学附属妇女儿童医院健康体检的1844例6月~12岁儿童,对25羟维生素D及抗-HBs浓度的检测结果进行分析,并对不同年龄段儿童的25(OH)VD水平与其抗-HBs抗体浓度的相关性进行探讨。结果该研究人群中维生素D缺乏占7.7%,不足占37.5%,正常占54.8%;乙肝疫苗免疫无应答占40.3%,低应答占32.7%,正常应答占27%。儿童维生素D充足组抗-HBs浓度中位数为26.1(4.5,159.3)mIU/mL,高于维生素D缺乏组及不足组的抗体浓度,差异有统计学意义(P<0.05)。在维生素D缺乏,不足及合适三组中乙肝疫苗免疫呈正常应答反应的人数构成比分别是24.6%,21.9%,30.8%,差异有统计学意义(χ^2=16.96,P<0.001)。从6月龄~12岁,儿童血清25-羟维生素D浓度与抗-HBs浓度均随年龄增长呈下降趋势,血清25-羟维生素D浓度与抗-HBs浓度呈正相关,相关系数为0.196(P<0.001)。结论血清维生素D缺乏相关的危险因素可能对儿童乙肝疫苗的免疫应答和抗体的持续存在产生负面影响。Objective To investigate the relationship between serum vitamin D nutritional status and hepatitis B vaccine immune response in children.Methods 1844Participants aged 6 months to 12 years old who had a physical examination in the Children and Children’s Hospital of Xiamen University from January 2016 to December 2018 were enrolled.The correlation between 25-hydroxyvitamin D levels in children of different ages and the concentration of the hepatitis B surface antibody was discussed.Results Vitamin D deficiency accounted for 7.7%of the study population,Vitamin D insufficient was 37.5%and normal levels accounted for 54.8%;the hepatitis B vaccine immune no response was 40.3%,the low response was 32.7%,and the normal response was 27%,respectively.The medium concentration of hepatitis B surface antibody in children with adequate vitamin D was 26.1(4.5,159.3)mIU/mL,which was higher than that of vitamin D deficiency group and insufficient group(P<0.05).The proportion of patients with vitamin D deficiency,insufficient and appropriate hepatitis B vaccine immunization was 24.6%,21.9%,30.8%,respectively,and the difference was statistically significant(χ^2=16.96,P<0.001).For children aged 6 months to 12 years,the concentration of 25-hydroxyvitamin D and anti-HBs decreased with age,The concentration of 25-hydroxyvitamin D concentration in serum was positively correlated with the concentration of anti-HBs,and the correlation coefficient was 0.196(P<0.001).Conclusion 25-hydroxyvitamin D in Serum may be associated with the maintenance of the effective level of anti-HBs antibody in children.

关 键 词：25-羟维生素D 儿童 乙型肝炎病毒疫苗 免疫反应 

分 类 号：R179[医药卫生—妇幼卫生保健]