母亲乙型肝炎病毒表面抗原阴性婴儿接种重组乙型肝炎疫苗(酵母)后的抗体无应答分析

Analysis on the Antibody Responses of Infants Whose Mother Were Negative for HBsAg Vaccinated With Recombinant Yeast Hepatitis B Vaccine

目的探讨母亲乙型肝炎(乙肝)病毒表面抗原(HBsAg)阴性婴儿,应用国产重组乙肝疫苗(酵母)常规接种后的乙肝病毒表面抗体(抗-HBs)应答状况及其特征。方法在河南省开封市筛选母亲HBsAg阴性的7～24月龄婴幼儿8 093例,按0、1、6个月程序接种5μg国产重组乙肝疫苗(酵母),用固相放射免疫法检测抗-HBs,对<10mIU/ml者的性别、城乡、不同月龄等特点进行分析。结果2 970例7～10月龄婴儿中,56例抗-HBs<10mIU/ml,无应答率为1.89%。其中1 911例城市婴儿中7例无应答(0.37%),1 059例农村婴儿中无应答者49例(4.63%),城乡婴儿抗-HBs无应答率的差异有非常显著的统计学意义(χ2=66.87,P<0.01),不同性别婴儿抗-HBs无应答率的差异无显著的统计学意义。城乡婴儿抗-HBs无应答率的差异与疫苗管理及接种质量综合评估呈显著负直线相关。婴儿11～24月龄间抗-HBs下降速度快,至22～24月龄时,已有15.53%抗-HBs阴转,较7～10月龄时增加8.22倍。结论母亲HBsAg阴性的婴儿常规接种5μg国产重组乙肝疫苗(酵母)后,抗-HBs无应答率为1.89%。城市低于农村。全程免疫后婴儿抗-HBs的下降速度快,提示应加大新生儿期疫苗的剂量,重组乙疫苗(酵母)可由5μg/剂提高到10μg/剂。

Objective To assess the antibody responses of infants whose mothers were negative for HBsAg vaccinated with recombinant yeast hepatitis B vaccine. Methods 8093 healthy infants aged 7-24 months old whose mothers were negative for HBsAg were vaccinated with hepatitis B vaccine according to 0,1,6 months schedule. Results Among 2970 infants aged 7- 10 months old, the anti-HBs titers of 56 infants were below 10mIU/mL （1.89 %）;The non-responses rate of city infants was significantly lower than that of rural areas （0. 37 %;4.63 %, P〈0.01 =）. The anti-HBs titers of infants aged of 11-24 months decreased fast,while the antibody titers of 15.53% of infants was below 10mIU/mL at 22-24 months. Conclusion This results showed that the non-responses rate of infants whose mother were negative for HBsAg vaccinated with recombinant yeast hepatitis B vaccine （5μg/dose） was 1.89%,with the higher non-responses rates of rural areas,and also suggested that higher dose of hepatitis B vaccine should be used for infant immunization （from 5μg/dose to 10μg/dose）.