40岁以上成人接种不同类型乙型肝炎疫苗的免疫效果及影响因素分析  

Analysis of immune efficacy and influencing factors of different types of hepatitis B vaccine in adults over 40 years old

作　　者：赵春艳[1] 孙远洁 石晶[1] 张建明 吴疆[2] 高培[2] ZHAO Chunyan;SUN Yuanjie;SHI Jing;ZHANG Jianming;WU Jiang;GAO Pei(Tongzhou District Center for Disease Control and Prevention,Beijing 101100,China;不详)

机构地区：[1]北京市通州区疾病预防控制中心,北京101100 [2]北京市疾病预防控制中心,北京102699

出　　处：《中国生物制品学杂志》2024年第9期1102-1108,共7页Chinese Journal of Biologicals

基　　金：首都卫生发展科研专项(首发2018-1-3011);北京市卫生系统高层次卫生技术人才队伍建设专项(学科骨干-3-043)。

摘　　要：目的分析北京市通州区≥40岁成人接种乙型肝炎(简称乙肝)疫苗(hepatitis B vaccine,HepB)的免疫效果及影响因素,为成人HepB免疫策略提供依据。方法选取≥40岁通州区常住人口且乙肝5项指标全部阴性者,随机分为3组,按照“0-1-6月”程序分别接种酿酒酵母HepB、汉逊酵母HepB、中国仓鼠卵巢细胞(CHO)HepB,免疫前及全程免疫后第1、6个月采血,检测乙肝表面抗体(抗-HBs),采用χ2检验、非参数检验、单因素和多因素Logistic回归分析抗体阳转率及影响因素;通过被动监测方式,收集研究对象接种疫苗后28 d内发生的疑似预防接种异常反应(adverse events following immunization,AEFI)事件。结果全程接种后1个月,3种疫苗抗-HBs总体阳转率为90.07%,几何平均浓度(geomtric mean concentration,GMC)为206.06 IU/L;6个月后抗-HBs总体阳转率为82.88%,GMC为68.17 IU/L,差异有统计学意义(χ^(2)=149.42,P<0.001;Z=-11.942,P<0.001)。多因素分析显示,不同疫苗种类是全程接种1、6个月抗-HBs阳转率的影响因素(OR>1,P<0.05),性别是全程接种6个月抗-HBs阳转率的影响因素(OR>1,P<0.05)。未收集到AEFI事件报告。结论40岁以上人群接种HepB 1和6个月后能产生良好的免疫效果,CHO、汉逊酵母组优于酿酒酵母组。应加大宣传力度,积极推广成人HepB接种,降低成人乙肝发病率。Objective To analyze the immune efficacy and influencing factors of hepatitis B vaccine(HepB)in adults(≥40 years)in Tongzhou District,Beijing,so as to provide scientific basis for adult HepB immunization strategy.Methods Permanent residents aged 40 years and older in Tongzhou District with negative hepatitis B five indexes were randomly divided into three groups.The three groups were inoculated with Saccharomyces cerevisiae HepB,Hansenula HepB,and Chinese hamster ovary(CHO)HepB according to the“0-1-6 months”schedule.Blood samples were collected before as well as the 1st and 6th month after full immunization for hepatitis B surface antibody(anti-HBs)detection.Theχ^(2)test,non-parametric test,univariate and multivariate Logistic regression were used to analyze antibody seroconversion rate and influencing factors.Through passive monitoring,the suspected adverse events following immunization(AEFI)occurred within 28d after vaccination were collected.Results One month after the full immunization,the overall seroconversion rate of anti-HBs of the three vaccines was 90.07%,and the geomtric mean concentration(GMC)was 206.06 IU/L.After six months,the overall seroconversion rate of anti-HBs was 82.88%and the GMC was 68.17 IU/L,with the significant difference(χ^(2)=149.42,P<0.001;Z=-11.942,P<0.001).Multivariate analysis showed that different vaccine types were the influencing factors of anti-HBs seroconversion rate after 1 and 6 months of full immunization(OR>1,P<0.05),while gender was the influencing factor after 6 months of full immunization(OR>1,P<0.05).In addition,No AEFI report was collected.Conclusion People over 40 years old could get good immune effect after inoculation of HepB for 1 and 6 months,and CHO HepB and Hansenula HepB groups were better than Saccharomyces cerevisiae HepB group.It is necessary to strengthen the propaganda and popularize the adult HepB vaccination so as to reduce the incidence of adult hepatitis B.

关 键 词：成人 乙型肝炎 乙型肝炎疫苗 免疫效果 影响因素 

分 类 号：R186[医药卫生—流行病学]