广州某高等医学院校研究生乙肝疫苗接种情况调查

Status of vaccination against hepatitis B among postgraduate students in medical higher education institutions in Guangzhou

目的了解广州某高等医学院校研究生乙肝疫苗接种情况，为乙肝防治工作提供依据。方法对广州某高等医学院校2006年入学的1139名研究生进行入学体检现况调查，采集血标本用ELISA法检测乙型肝炎表面抗原（HBsAg）和表面抗体（HBsAb）。同时发放乙肝疫苗接种情况调查表，调查乙肝疫苗接种的年代、次数，是否加强接种及时间。用SAS统计软件包对结果进行X^2检验分析。结果广州某高等医学院校06级研究生HBsAg阳性率为2．90％，曾注射乙肝疫苗组，HBsAg阳性率显著低于从未注射疫苗组（1．15％ vs． 21．69％，P〈0．0001），而HBsAb阳性率则显著高于从未注射疫苗组（81．54％ vs．44．58％，P〈0．0001）。有17．31％曾接种乙肝疫苗者未能达到预期预防效果。不同年龄研究生乙肝疫苗接种效果有差异（P=0．0462），随着年龄的增加，HBsAb阳性率有下降趋势。女性乙肝疫苗接种效果较男性好（80．0％ vs．84．87％，P=0．0468）。接种年限在3年内者，HBsAb阳性率较其他年限高（0—3年 vs．4—6年，P=0．0089；0—3年 vs．7—9年，P=0．0172；0—3年 vs．〉9年，P=0，0474）。注射大于3针（即加强接种）免疫效果较注射3针者好，差异有统计学意义（P=0．0093）。结论随着年龄的增加，乙肝疫苗接种效果（HBsAb阳性率）逐渐降低。男性群体较女性群体更易成为乙型肝炎病毒的易感人群。对接种年限大于3年者，可进行抗-HBs监测，及时进行加强免疫。

Objective To investigate the status of vaccination against hepatitis B among postgraduate students of medical institutions of higher education in Guangzhou, Methods HBsAg and anti-HBs in the serum samples from 1139 postgraduate students were detected by EHSA. Data on hepatitis B vaccine inoculation were investigated by using a questionnaire. Statistical analyses were performed by using SAS software. Results The HBsAg positive rate among the 1139 postgraduate students was 2.90% .The HBsAg positive rates in hepatitis B vaccine inoculated （ 1.15 % ） and non-inoculated （ 21.69 % ） postgraduate students were significantly different （ X2 = 119. 11, P 〈 0.0001） .The positive rates of HBsAb between the two groups were also significantly different（ 2 = 62.05, P 〈 0.0001 ）. Among the hepatitis B vaccine inoculated students, 17.31% were negative for HBsAb. The positive rate of HBsAb among those inoculated the vaccine within the past 3 years was higher than that among those inoculated the vaccine earlier（0-3 years vs. 4-6 year, P = 0.0089;0-3 years vs. 7-9 years, P = 0.0172;0-3 years vs. 〉 9 years, P = 0.0474）. The positive rate of HBsAb among the students who received hepatitis B vaccine booster dose was higher than that of the students who did not receive any booster dose（ P = 0.0093）. Conclusion With the increase of ages, the effect of vaccination for hepatitis B decreased. Male populations may be more susceptible to hepatitis B virus than female. It is necessary to monitor HBsAb levels for those who were inoculated with HBV vaccine more than 3 years ago to give booster dose in time to prevent HBV infection.