非酒精性脂肪性肝病及原发性肝细胞癌患者接种新型冠状病毒灭活疫苗的安全性及免疫原性  

Safety and immunogenicity of SARS-CoV-2 inactivated vaccination in patients with NAFLD and liver cancer

作　　者：刘星 吴威[2] 张晓明[3] 李强 权冬梅 张朕 戴越 张麟格 宋冠男 李欣悦 朱一丹 王岩[1] Liu Xing;Wu Wei;Zhang Xiaoming;Li Qiang;Quan Dongmei;Zhang Zhen;Dai Yue;Zhang Linge;Song Guannan;Li Xinyue;Zhu Yidan;Wang Yan(Science and Education Department,The Sixth People's Hospital of Shenyang,Shenyang,110006,China;Diagnosis and Treatment Center of Hepatocellular Carcinoma,The Sixth People's HosPital of Shenyang,Shenyang 110006,China;Clinical Laboratory,The Sixth People's HosPital of Shenyang,Shenyang 110006,China;Department of General Thoracic Surgery and Breast and Endocrinological Surgery,Graduate School of Medicine Dentistry and Pharmaceutical Sciences,Okayama University,Okayama 700-8530,Japan)

机构地区：[1]沈阳市第六人民医院科教科,沈阳110006 [2]沈阳市第六人民医院肝癌诊治中心,沈阳110006 [3]沈阳市第六人民医院检验科,沈阳110006 [4]日本冈山大学医齿药学综合研究所呼吸器乳腺内分泌外科,冈山700-8530

出　　处：《新发传染病电子杂志》2022年第3期50-54,共5页Electronic Journal of Emerging Infectious Diseases

基　　金：沈阳市新发突发传染病诊断及治疗医学研究中心项目。

摘　　要：目的探讨新型冠状病毒疫苗在非酒精性脂肪性肝病(NAFLD)患者以及原发性肝细胞癌患者中的安全性及免疫原性。方法纳入2020年12月至2021年10月到沈阳市第六人民医院就诊自愿接种新型冠状病毒灭活疫苗的健康人群30例(健康组)、NAFLD患者30例(NAFLD组)、原发性肝细胞癌患者10例(肝癌组)以及新型冠状病毒肺炎(COVID-19)患者10例(COVID-19组)。健康组、NAFLD组接种3剂灭活疫苗;肝癌组接种2剂灭活疫苗,检测每剂疫苗接种后中和抗体及肝功能水平,在前2剂疫苗每次接种后对健康组和肝癌组进行T淋巴细胞亚群计数,同时记录各组人群疫苗接种后不良反应发生状况。并检测COVID-19患者治愈后半年的中和抗体水平。结果健康组、NAFLD组和肝癌组三组人群随着疫苗接种剂次增加,中和抗体水平呈现逐渐上升的趋势,健康组和NAFLD组接种第3剂疫苗后中和抗体水平均高于COVID-19患者临床治愈后半年的水平。健康人群和肝癌患者接种疫苗后均表现出CD4~+T淋巴细胞和CD4~+T淋巴细胞百分比升高,同时伴有CD8~+T淋巴细胞的增加。注射部位疼痛是最常见的不良反应。结论新型冠状病毒灭活疫苗对肝病患者具有较好的安全性和免疫原性。第3剂疫苗加强接种尤其适用于少数需要加大疫苗剂量以获得更好反应的肝病患者以及接种常规2剂疫苗无法产生免疫应答的特定人群。Objective To investigate the safety and immunogenicity of COVID-19 vaccination in patients with nonalcoholic fatty liver disease(NAFLD)and patients with primary hepatocellular carcinoma(HCC).Method Ten COVID-19 patients who had been infected with SARS-CoV-2 and people who voluntarily vaccinated with COVID-19 inactivated vaccine(including 30 Healthy people,30 NAFLD patients and 10 HCC patients)between December 2020 and October 2021 in the Sixth People’s Hospital of Shenyang were enrolled in the study.The healthy group and NAFLD group were vaccinated with 3 doses and the HCC group was vaccinated with 2 doses.The neutralizing antibody(nAb)and liver function after each dose were detected,and the T lymphocyte subsets of the healthy group and the HCC group were tested after the first two doses.The occurrence of adverse reactions after vaccination in each group was recorded.The nAb of COVID-19 patients after 6 months’treatment was also detected.Result The nAb level in healthy group,NAFLD group and HCC group increased gradually with the increase of vaccine doses.The nAb level in healthy group and NAFLD group after the third dose of vaccine were higher than those in COVID-19 patients after 6 months’treatment.CD4T and CD4T%were increased in both healthy group and HCC group after vaccination,accompanied by an increase of CD8T.Injection site pain was the most common adverse reaction.Conclusion COVID-19 inactivated vaccination was safety and has good immunogenicity in patients with liver disease.The third dose is especially suitable for a small number of patients with liver diseases who need to increase the vaccine dose to obtain a better response,and specific people who cannot produce immune response by conventional two doses.

关 键 词：新型冠状病毒 新型冠状病毒肺炎 疫苗 非酒精性脂肪性肝病 肝癌 

分 类 号：R575.5[医药卫生—消化系统] R735.7[医药卫生—内科学] R186[医药卫生—临床医学]