厦门市2231名儿童乙型肝炎血清学调查结果分析  

Analysis on serological survey of 2 231 children with hepatitis B in Xiamen

作　　者：陈水利 林志青[1] 黄蕊[1] 赵红缨 郭志峰[1] 陈凌[1] CHEN Shui-li;LIN Zhi-qing;HUANG Rui;ZHAO Hong-ying;GUO Zhi-feng;CHEN Ling(Department of Pediatrics,Zhongshan Hospital Affiliated to Xiamen University,Xiamen,Fujian 361004,China)

机构地区：[1]厦门大学附属中山医院儿科,福建厦门361004

出　　处：《医学动物防制》2021年第10期959-962,共4页Journal of Medical Pest Control

摘　　要：目的调查厦门市完成乙肝疫苗三针基础免疫后的儿童乙肝表面抗原(HBsAg)阳性率及乙肝表面抗体(Anti-HBs)阳性率,评价现阶段厦门市儿童乙肝的免疫预防控制效果。方法回顾性收集2015年6月—2019年5月在厦门大学附属中山医院进行健康体检的2 231名7月~14岁儿童血清标本。全部儿童依据年龄分为7月~3岁、>3~7岁、>7~10岁、>10~14岁4个组。采用酶联免疫吸附试验法(ELISA)定量检测HBsAg和Anti-HBs滴度情况。应用卡方检验比较不同性别、各年龄组的HBsAg和Anti-HBs阳性率,应用秩和检验比较各年龄组乙肝免疫应答情况。结果共收集儿童血清2 231份,HBsAg阳性率为0.85%(19/2 231),Anti-HBs阳性率为57.01%(1 272/2 231)。不同年龄儿童血清Anti-HBs阳性率不同,差异有统计学意义(χ^(2)=202.188,P<0.01)。其中7月~3岁儿童Anti-HBs阳性率最高(88.86%),>7~10岁儿童Anti-HBs阳性率最低(42.21%)。不同年龄组乙肝免疫应答水平亦不相同,其中7月~3岁、>3~7岁、>7~10岁及>10~14岁组低应答率分别为32.15%、65.08%、34.29%及23.58%,差异有统计学意义(H=88.212,P<0.01)。结论出生后规范接种乙肝疫苗的儿童Anti-HBs阳性率随着年龄的增长逐渐下降,3岁后下降明显,有必要在3岁后加强定期乙肝血清学标志物监测。Objective To investigate the positive rate of hepatitis B surface antigen(HBsAg) and hepatitis B surface antibody(Anti-HBs) in children after three basic immunizations with hepatitis B vaccine, and to evaluate the effect of prevention and control of hepatitis B in children in Xiamen at the current stage.Methods The serum samples of 2 231 children from July to 14 years old receiving health examinations in Zhongshan Hospital Affiliated to Xiamen University from June 2015 to May 2019 were retrospectively collected.All the children were divided into four groups including the 7 months-3 years group, >3-7 years group, >7-10 years group and >10-14 years group.HBsAg and Anti-HBs titers were quantitatively detected by enzyme-linked immunosorbent assay(ELISA).Chi-square test was used to compare the positive rate of HBsAg and Anti-HBs in different genders and age groups, and the rank sum test was used to compare the immune response of hepatitis B.Results A total of 2 231 children serums were enrolled,the positive rate of HBsAg positivity and Anti-HBs was 0.85%(19/2 231) and 57.01%(1 272/2 231) respectively.The positive rate of Anti-HBs in children at different ages varied, and the difference was statistically significant(χ^(2)=202.188,P<0.01).The positive rate of Anti-HBs in children was the highest in the 7 months-3 years group(88.86%),and that was lowest for children in the >7-10 years age group(42.21%).The level of immune response to hepatitis B varied among different age groups, the response rate of children in the 7 months-3 years group, >3-7 years group, >7-10 years group and >10-14 years group was 32.15%,65.08%,34.29% and 23.58% respectively, and the difference was statistically significant(H=88.212,P<0.01).Conclusion The positive rate of Anti-HBs in children who are vaccinated against hepatitis B regularly after birth decreases gradually with the increase of the age, especially after 3 years of age, and it is necessary to tighten regular monitoring on hepatitis B serological markers aged older than 3 years.

关 键 词：乙肝疫苗 乙肝表面抗原 乙肝表面抗体 免疫应答 血清学标志物 

分 类 号：R512.62[医药卫生—内科学]