新生儿血源乙型肝炎疫苗免疫后14年效果评价  

An Evaluation on Effectiveness of Plasma-derived Hepatitis B Vaccine Immunization to Newborns after 14-years

作　　者：马景臣 刘洪斌[2] 张英林 孟宗达[2] 韩常全 邢占春 张玉伟 赵卉 孙永德[2] 夏国良[3] 曹惠霖[3] 刘崇柏[3] 

机构地区：[1]正定县卫生防疫站,河北正定050800 [2]河北省疾病预防控制中心,石家庄050021 [3]中国疾病预防控制中心病毒病预防控制所,北京100052

出　　处：《中国计划免疫》2003年第3期133-135,共3页Chinese Journal of Vaccines and Immunization

基　　金："九五"国家科技攻关课题资助项目 ( 96-90 6-0 3 -0 2 )

摘　　要：为了解新生儿血源乙型肝炎 (乙肝 )疫苗免疫后的乙肝病毒表面抗体 (抗 HBs)持久性及长期保护效果 ,1986～ 1989年 ,在正定县吴兴乡 7个自然村结合农村计划免疫活动 ,给新生儿接种 3针 10 μg/ml血源乙肝疫苗 ,并以免疫后首次检测乙肝病毒表面抗原 (HBsAg)阴性的 76 2人为研究对象 ,进行了 14年的随访观察。结果显示 :乙肝疫苗免疫后 14年间 ,HBsAg阴性和阳性母亲所生儿童的抗 HBs阳性率 ,分别由最高的 94 4 4 %和 95 83%逐年降至5 0 %左右 ,至 10～ 14年波动于 4 0 %～ 5 0 % ;抗 HBs有效阳性率的动态变化与阳性率相似 ,10～ 14年基本维持在2 0 %左右。 14年间对HBsAg阴性和阳性母亲所生儿童共随访观察了 76 12 5人年 ,发现HBsAg阳转者 6例 ,HBsAg年阳转率为 0 0 8% ,与本底对照的 1 13%相比 ,保护率为 92 92 %。这 6例HBsAg阳转者在之后的多次检查中均HB sAg阴性 ,未形成HBsAg慢性携带者。表明血源乙肝疫苗的长期保护效果良好 ,14年内无需加强接种。In order to understand the anti-HBs persistence and the long-term preventive efficacy in newborns after vaccination with plasma-derived hepatitis B vaccine,a cohort observation was carried out in the following 1～14 years in Zhengding County,Hebei Province.The newborns were vaccinated with 10ug/ml×3 doses of hepatitis B vaccine,and 762 newborns who were HBsAg negative after primary immunization were selected for a cohort observation from 1986 to 1989.Their serum samples were detected qualitatively for hepatitis B infecting markers,including HBsAg,anti-HBs and anti-HBc by SPRIA Kits.The annual HBsAg positive seroconversion rate was counted by life-table method.The results showed that the anti-HBs positive rates were from 94.44% to 57.89% for babies born to HBsAg negative mothers and from 95.83% to 62.26% for babies born to HBsAg positive mothers at the 1 st to 9 th year,and still 50% or so at the 10 th to 14 th year.The person-year HBsAg positive seroconversion rate was 0.08%(6/7612.5),and none of the HBsAg positively converted children became HBsAg chronic carriers.Compared with the baseline(1.13%)before immunization,the protective rate was 92.92%.In conclusion,the protective efficacy of plasma-derived hepatitis B vaccine persisted at least 14 years,and a booster dose seems not necessary within at least 14 years after the primary three-doses immunization to newborns.

关 键 词：新生儿 血源乙型肝炎 疫苗 免疫 

分 类 号：R512.62[医药卫生—内科学] R186[医药卫生—临床医学]