潘引君, 邵杏芳, 李燕婷, 黎健, 费金花, 段蓉, 潘俊锋, 魏延. 上海青浦区新生儿乙型肝炎疫苗免疫效果及低、无应答者再免疫效果[J]. 环境与职业医学, 2011, 28(11): 672-674,683.
引用本文: 潘引君, 邵杏芳, 李燕婷, 黎健, 费金花, 段蓉, 潘俊锋, 魏延. 上海青浦区新生儿乙型肝炎疫苗免疫效果及低、无应答者再免疫效果[J]. 环境与职业医学, 2011, 28(11): 672-674,683.
PAN Yin-jun , SHAO Xing-fang , LI Yan-ting , LI Jian , FEI Jinhua , DUAN Rong , PAN Jun-feng , WEI Yan . Effectiveness of Hepatitis B Vaccine Immunization on Infants and Reimmunization on Low-and NonResponders in Qingpu District, Shanghai[J]. Journal of Environmental and Occupational Medicine, 2011, 28(11): 672-674,683.
Citation: PAN Yin-jun , SHAO Xing-fang , LI Yan-ting , LI Jian , FEI Jinhua , DUAN Rong , PAN Jun-feng , WEI Yan . Effectiveness of Hepatitis B Vaccine Immunization on Infants and Reimmunization on Low-and NonResponders in Qingpu District, Shanghai[J]. Journal of Environmental and Occupational Medicine, 2011, 28(11): 672-674,683.

上海青浦区新生儿乙型肝炎疫苗免疫效果及低、无应答者再免疫效果

Effectiveness of Hepatitis B Vaccine Immunization on Infants and Reimmunization on Low-and NonResponders in Qingpu District, Shanghai

  • 摘要: 目的 调查青浦区新生儿乙型肝炎(乙肝)疫苗基础免疫应答效果及影响因素;探讨低、无应答新生儿再免疫后免疫应答效果。

    方法 采用单纯随机抽样方法,抽取青浦区2008年2月1日-2009年3月30日出生新生儿按照"0-1-6"免疫程序全程分别接种5μg啤酒酵母乙肝疫苗或10μg汉逊酵母乙肝疫苗的新生儿677名作为调查对象,采用化学发光微粒子免疫分析法检测抗乙肝病毒表面抗原抗体(antibody to hepatitis B virus surface antigen,anti-HBs),并对其家长进行问卷调查以了解婴儿出生和疫苗接种情况。

    结果 研究调查的677名新生儿中全程初免乙肝疫苗后抗乙肝病毒表面抗原抗体应答率为82.72%,有117名低、无应答新生儿低、无应答率为17.28%,(其中无应答率2.22%,低应答率15.07%);10 μg接种剂量组免疫应答率高于5 μg接种剂量组。多因素分析显示,女性、接种10 μg汉逊酵母、足月儿的应答水平较高,OR分别为1.529、3.617、9.356。对低、无应答者再免疫第一针与第三针后anti-HBs免疫应答率分别为91.40%和94.50%;对低、无应答者再免疫第一针、第三针后新生儿anti-HBs抗体应答率较初免后anti-HBs抗体应答率均有统计学差异(P < 0.05)。

    结论 新生儿全程初免乙肝疫苗后anti-HBs应答率较高,但也存在17.28%低、无应答者;母亲分娩前乙肝病毒表面抗原(hepatitis B virus surface antigen,HBsAg)阳性、早产、乙肝疫苗接种剂量是乙肝疫苗免疫应答率的影响因素;对低、无应答新生儿应该再免疫一针10μg汉逊酵母乙肝疫苗。

     

    Abstract: Objective To study the infants' basic responses to hepatitis B vaccination and the influencing factors in Qingpu District of Shanghai and probe the responses to re-vaccination of those who showed no or low response in the prior.

    Methods With simple random sampling, a total of 677 infants, who were born from February 1, 2008 to March 30, 2009 in Qingpu District of Shanghai and vaccinated with 5μg recombinant beer yeast-derived hepatitis B vaccines (YDVs) or 10μg Hansenula YDVs according to the 0-1-6 immunization schedule, were enrolled as the study subjects. The antibody to hepatitis B surface antigen (anti-HBs) was detected by chemiluminescence microparticle immuno assay. Questionnaires were also employed among the parents to investigate the birth and vaccination course.

    Results Of all the 677 infants enrolled, the response rate of the first-course immunity was 82.72%, and the low/non-response rate was 17.28% (2.22% non-response and 15.07% low-response). The group vaccinated with 10μg Hansenula YDVs showed a higher response rate than the group accepted 5 μg beer YDVs. Logistic regression analysis showed a higher response rate in the infants who were female, vaccinated with Hansenula YDVs or full-term (OR=1.529, 3.617 or 9.356, respectively). Among those who showed no or low response after the first course of vaccination, the response rate of the first and the third shots in the second course vaccination were 91.40% and 94.50% respectively. The response rates of the first and the third shots in the second course of vaccination were obviously higher than that in the first course (P < 0.05).

    Conclusion The infants who received a full course of the hepatitis B vaccination showed a higher response rate of anti-HBs, but there were still 17.28% of them showed low/nonresponse. Premature birth, low dosage of vaccine inoculated and mothers with positive hepatitis B surface antigen (HBsAg) are the risk factors for low/non-response. Such infants should be re-vaccinated with another 10μg of Hansenula YDVs.

     

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