广东省实施新生儿乙肝疫苗接种后免疫效果评价

Effects of immunization of hepatitis B vaccine for new-born infants in Guangdong province

目的评价实施新生儿乙肝疫苗接种后的免疫效果。方法采用多阶段随机抽样方法,于2006年9月在广州市越秀区、云浮市云城区、汕尾市城区、肇庆四会市、韶关南雄县、梅州五华县等6个国家疾病监测点,抽取1～14岁儿童进行调查,用酶联免疫吸附试验方法检测HBV血清标志物[乙肝病毒表面抗原(HBsAg)、乙肝病毒表面抗体(抗-HBs)、乙肝病毒核心抗体(抗-HBc)],并与1992年同年龄段儿童的HBV流行情况进行比较。结果共调查1951名1～14岁儿童,其乙肝疫苗全程接种率为59.7%(1165/1951),其中1～4岁为88.8%(649/731),5￣14岁为42.3%(516/1220);1￣14岁儿童中免疫组HBsAg阳性率(2.3%,28/1211)低于未免疫组(10.8%,18/167)和免疫史不详组(7.5%,43/573),差异有统计学意义(P<0.01);乙肝疫苗首针在出生后当天或第2天接种儿童的HBsAg阳性率为1.4%(10/734),低于第3天以后才接种者(3.8%,18/477),差异有统计学意义(P<0.05);1￣14岁儿童HBsAg阳性率为4.6%(89/1951),其中1￣4岁儿童HBsAg阳性率为1.9%(14/731),与1992年比较分别下降了76.9%、88.6%(P<0.01)。结论实施新生儿乙肝疫苗接种取得良好免疫效果,出生后及时接种免疫效果更好。

Objective To evaluate effects of immunization of hepatitis B vaccine for new-born infants. Methods A multi-stage random sampling method was performed to select children aged 1-14 years from 6 national surveillance spots of Yuexiu region, Yuncheng region, Shanwei city, Sihui city, Nanxiong county and Wuhua county in September 2006. Serologic indicators of HBV like HBsAg,antiHBs and anti-HBc were detected using ELISA and compared with data in 1992. Results The whole process coverage rate of Hepatitis B vaccine was 59.7%（1 165/1 951） among 1 951 investigated children, with 88.8%（649/731） and 42.3%（516/1 220） in 1-4 and 5-14 age group. The HBsAg positive rate found significantly lower in vaccinated group than no and unknown vaccinated group （P〈0.01）. Children who were immunized first dose on the first or second day postnatal had positive rate of 1.4%（10/734）, which was significantly lower than ≥3 days＇ group （3.8%, 18/477）. The HBsAg positive rate of 1-14 years old children dropped from 19.9% in 1992 to 4.6% in 2006 as well as for 1-4 age group from 16.7% to 1.9%. Conclusions Immunization of hepatitis B vaccine was effective to prevent HBV infection with better effects by the earlier first dose.