河北省正定县1986—1996年出生人群乙型肝炎疫苗基础免疫后21~32年加强免疫效果分析  

The effect of booster dose vaccination 21‑to 32‑years after primary vaccination with hepatitis B vaccine in the population born from 1986 to 1996 in Zhengding County of Hebei Province

作　　者：张新江[1] 吴志伟 张艳红[1] 李敏捷 周海松[1] 韩碧华 郝志勇[1] 褚娟[1] 高招 马景臣[2] 赵玉良[2] Zhang Xinjiang;Wu Zhiwei;Zhang Yanhong;Li Minjie;Zhou Haisong;Han Bihua;Hao Zhiyong;Chu Juan;Gao Zhao;Ma Jingchen;Zhao Yuliang(Zhengding County Center for Disease Control and Prevention,Shijiazhuang 050800,China;Hebei Province Center for Disease Control and Prevention,Shijiazhuang 050021,China)

机构地区：[1]河北省石家庄市正定县疾病预防控制中心,050800 [2]河北省疾病预防控制中心疫苗临床研究所,石家庄050021

出　　处：《中华预防医学杂志》2020年第9期942-946,共5页Chinese Journal of Preventive Medicine

基　　金：国家科技重大专项(2018ZX10721202);河北省科技厅指导项目(162777290)。

摘　　要：目的分析河北省正定县人群乙型肝炎疫苗(HepB)基础免疫21~32年后加强免疫的效果。方法2017年8月至2018年2月选取正定县1986—1996年出生、完成血源HepB基础免疫且无加强免疫史人群中,乙型肝炎病毒表面抗原(HbsAg)、抗‑HBc(HbcAb)均阴性且抗‑HBs<10 mIU/ml,以及最终完成加强免疫且有实验室结果者为研究对象,共322名。采用简单随机分组方法将322名研究对象随机分为2组,分别接种1剂市售的啤酒酵母HepB[以下简称HepB(酵母);151名]和基因重组HepB[以下简称HepB(CHO);171名],剂量均为20μg。免疫后30 d采集静脉血5 ml,定量检测抗‑HBs的几何平均浓度(GMC),观察加强免疫效果,采用多元线性回归和多因素logistic回归模型分析研究对象加强免疫后抗‑HBs的GMC和阳转率的相关因素。结果研究对象抗‑HBs阳转率为82.61%(266名),GMC为(131.63±12.94)mIU/ml。加强免疫前抗‑HBs<2.5和2.5~10 mIU/ml组加强免疫后抗‑HBs阳转率分别为74.54%(161名)和99.06%(105名)(P<0.001);加强1剂HepB(CHO)后,抗‑HBs阳转率高于加强1剂HepB(酵母),分别为87.13%(149名)和77.48%(117名)(P=0.023)。与接种HepB(酵母)相比,接种HepB(CHO)是加强免疫后抗体阳转的相关因素,OR(95%CI)值为1.91(1.02~3.56)(P=0.042);与加强免疫前抗‑HBs<2.5 mIU/ml相比,加强前抗体水平2.5~10 mIU/ml是加强免疫后抗体阳转的相关因素,OR(95%CI)值为36.15(4.91~266.02)(P<0.001)。结论研究对象接种1剂乙型肝炎疫苗有良好的免疫应答;加强免疫前抗‑HBs水平和加强用疫苗种类是免疫应答的相关因素。Objective Aanalysis the effect of booster one dose of hepatitis B vaccine after 21-32 years of primary immunization in Zhengding Country of Hebei Province.Methods A total of 322 participants who were born between 1986 and 1996,received a full course of primary vaccination with plasma‑derived hepatitis B vaccine(HepB),had no experience with booster vaccination,were HBsAg,anti‑HBcnegative,had anti‑HBs<10 mIU/ml,completed the booster and had laboratory results were enrolled between August 2017 to February 2018.A simple random method was uesd to randomly assigned 322 subjects to two groups,receiving a booster dose of HepB derived from either Saccharomyces cerevisiae[HepB(SC),(151 cases)]or Chinese hamster ovary‑derived HepB[HepB(CHO),(171 cases)],the dose was 20μg.Blood samples were collected 30 days after boosting and quantitatively tested for the geometric mean concentration(GMC)of anti‑HBs to assess immunological effect.The related influencing factors of GMC and seroconversion rates of anti‑HBs were analyzed by multiple linear regression and multivariate logistic regression models.Results The 266 subjects(82.61%)had anti‑HBs≥10 mIU/ml,and GMC was(131.63±12.94)mIU/ml.The seroconversion rates of anti‑HBs in the anti‑HBs<2.5 mIU/ml group and 2.5-10 mIU/ml group were 74.54%(161 cases)and 99.06%(105 cases),respectively(P<0.001).The seroconversion rates of anti‑HBs after one dose of HepB(CHO)was higher than that of one dose of HepB(SC),the seroconversion rates were 87.13%(149 cases)and 77.48%(117 cases),respectively(P=0.023).Participants boostered with HepB(CHO)was the factor influencing the effect of strengthening immunization compared with boostered with HepB(SC),and OR(95%CI)was 1.91(1.02-3.56)(P=0.042).Compared with anti‑HBs<2.5 mIU/ml,prebooster anti‑HBs was between 2.5 mIU/ml and 10 mIU/ml was the related factor of seroconversion rates of anti‑HBs after booster immunization,and OR(95%CI)was 36.15(4.91-266.02)(P<0.001).Conclusion Participants boostered withone dose of HepB had a good i

关 键 词：肝炎疫苗 乙型 加强免疫 免疫记忆 队列研究 

分 类 号：R186[医药卫生—流行病学]