北京市乙肝疫苗初免后3～12岁儿童加强免疫观察

Study on reminiscent responsion of Hepatitis B vaccine booster immunization in 3～12 years-old children of Beijing

目的 评价北京市儿童进行乙肝疫苗加强免疫接种后抗-HBs的应答反应水平。方法 采取多阶段整群系统抽样选择已进行乙肝疫苗初免的3～12岁儿童，采用固相放射免疫（SPRIA）方法。检测血清HBsAg、抗-HBs和抗-HBc水平。其中抗-HBs〈10Iu／L者进行不同剂量的己肝疫苗加强免疫。观察加强免疫后的抗-HBs。结果 2491名3～12岁儿童的抗-HBs阴性率为48．25％（CI％=35．15～64．26）；对其中726名儿童进行己肝疫苗加强免疫后。接种2．5和5μg疫苗的儿童抗-HBs的阳转率分别为90．6％和90．9％，GMT分别为85．69和87．59Iu／L，（X^2=0．02，P=0．89；t=0．36，P=0．72）。加强免疫后4～5周，平均抗-HBs的阳转率为92．8％，GMT为84．55Iu／L；免后6～22周采血，平均抗-HRs的阳转率为86．66％，GMT为91．39Iu／L，2个时间段的抗。HBs的阳转率差异有统计学意义（X^2=7．47，P=0．006）。结论 3～12岁完成乙肝疫苗基础免疫的儿童，在抗体消失后给予一定剂量的乙肝疫苗进行加强免疫，其抗-HtKs反应良好，表明机体存在对乙肝病毒有回忆反应，可能是维持乙肝疫苗长期保护效果的原因之一。

Objective To evaluate the character of the reminiscent responsion of the Hepatitis B vaccmebooster immunization on the children who were anti - FIBs negative in Beijing. Methods The multiple stratified cluster sampling was used in this epidemiological survey. The sampling children＇ s blood serum HBsAg, anti-HBs and anti-HBc were checked and measured by the Solid Phase Radioimmunoassay（SPRIA）, The children whose anti-HBs serological titer （GMT）was lower than 10 Iu/L had the Hepatitis B vaccine booster immunization in two different dosages. Results 2 419 3- 12 years-old children who were immunized by the Hepatitis B vaccine in the infant period were surveyed and the total anti - HBs negative rate was 48.25 % （CI %, 35.15- 64.26）. 725 children had the Hepatitis B vaccine booster immunization and the anti-HBs positive rate was observed. The anti-HBs positive rate of the children who were immunized in 2.5μg and 5.0μg Hepatitis B vaccine was 90.6 % and 90.9 % respectively. The GMT was 85.69 and 87.59 Iu/L respectively. The anti HBs positive rate was also analyzed according to the different time of the blood sampling, And there were both no statistical significances between the two dosages （X^2 = 0.02, P=0.89 ; t = 0.36, P = 0.72）. The average anti-HBs positive rate was 92,80 % and the GMT was 84.55 Iu/L after 4-5 weeks,The average anti-HBs positive rate was 86.66%and the GMT was 91.39 Iu/L after 6-22 weeks, There were statistical significance for the average anti-HBs positive rate（;（2 = 7.47. P = 0.006） and no statistical significance for the anti-HBs GMT between the different blood samplmg time （ t = 1.09, p = 0.28）. Conclusion For the 3 - 12 years-old children who had finished the basic immunization of Hepatitis B vaccine in the infant period, a little dose of Hepatitis B vaccine could make responsion strongly in their bodies after the antibody died away, It showed that there was remimscent responsion for the Hepatitis B virus in their bodies, This reminiscent responsion could be the main cause that made people have the long-term protection of Hepatitis B vaccine.