HBsAg阳性母亲的新生儿接种乙肝疫苗后的免疫应答远期保护效果研究  

Study on the long-term protective effect of immune response of newborns of HBsAg positive mothers after hepatitis B vaccination

作　　者：安和兵[1] 吕佳 王腾飞 常永峰[1] 杨敬芳[1] AN Hebing;LV Jia;WANG Tengfei(The Second Affiliated Hospital of Hebei North University,Hebei,Zhangjiakou 075100,China)

机构地区：[1]河北北方学院附属第二医院,河北省张家口市075100

出　　处：《河北医药》2021年第17期2654-2656,2660,共4页Hebei Medical Journal

基　　金：张家口市科学技术研究与发展攻关计划项目(编号:1621032D)。

摘　　要：目的探讨HBsAg阳性母亲的新生儿接种乙肝疫苗后的免疫应答远期保护效果。方法选择2015年2月至2018年2月分娩的乙肝表面抗原(HBsAg)阳性母亲的子女156例,分析其出生后的乙肝疫苗接种情况和随访记录。结果156例婴儿中实际随访134例(85.90%),7月龄随访时未发现隐匿感染HBV者,母婴阻断失败3.73%,抗-HBs阳性率为94.78%,无应答者为1.49%。68例加强免疫婴儿抗-HBs的浓度由64.86 U/L(2岁龄)升高至312.34 U/L(3岁龄),差异有统计学意义(Z=34.53,P<0.05);抗-HBs阳性率由66.18%升高至91.18%,差异有统计学意义(χ^(2)=21.43,P<0.05)。31例未接受加强免疫的婴儿抗-HBs浓度由208.43 U/L(2岁龄)降低至83.63 U/L(3岁龄),差异有统计学意义(Z=26.35,P<0.05);抗-HBs阳性率由64.52%降低至41.94%,差异有统计学意义(χ^(2)=22.86,P<0.05)。结论HBV感染母亲的新生儿接种乙肝疫苗和HBIG后具有较高的母婴阻断效果,抗-HBs水平可随年龄的增长而衰减,但仍有部分免疫应答者可获得远期保护效果。Objective To investigate the long-term protective effect of immune response of newborns of HBsAg positive mothers after vaccination with hepatitis B vaccine.Methods A total of 156 neonates delivered by HBsAg positive mothers in our hospital from February 2015 to February 2017 were enrolled in the study.The inoculation status of hepatitis B vaccine and follow up dat were analyzed.Results Of the 156 infants,134 cases(85.90%)were actually followed up,3.73%of them failed to mother to child blocking of HBV,94.78%of them were anti HBS positive,1.49%of them were unresponsive.The concentration of anti-HBs in 68 infants was increased from 64.86U/L(2 years of age)to 312.34U/L(3 years of age),the difference was statistically significant(P<0.05),and that of anti-HBs rate increased from 66.18%to 91.18%,the difference was statistically significant(P<0.05).The concentration of anti HBS in 31 infants who did not receive intensive immunization was decreased from 208.43U/L(2 years of age)to 83.63U/L(3 years of age),the difference was statistically significant(P<0.05),moreover,the anti HBS rate was decreased from 64.52%to 41.94%(P<0.05).Conclusion The effects of mother to child blocking of HBV are obvious in the neonates of HBV infected mother who receive hepatitis B vaccine and HBIG,and the levels of anti HBS are decreased with the increase of age,but some of the immune responders still have long-term protection effects.

关 键 词：HBSAG 新生儿接种 乙肝疫苗 免疫应答 远期保护 

分 类 号：R512.62[医药卫生—内科学]