HBsAb阴性者接种乙肝疫苗后影响HBsAb无或弱应答因素的探讨

Discussion of HBsAb weak or non-response affecting factors after HBsAb negative impact on immunization hepatitis B vaccine

目的:探讨HBsAb阴性者接种乙肝疫苗后影响HBsAb无或弱应答的因素。方法:乙肝病毒血清标志物(HBV-M)检测,采用ELISA方法;HBV-DNA检测,采用实时荧光定量PCR检测。结果:①4951名高中学生中,88.0%(4356/4951)有乙肝疫苗接种史,城镇学生(99.0%)显著高于农村学生(82.5%)(P<0.01);8.6%(425/4951)血清HBsAg和或HBeAg阳性者,其中369名其父母或祖父母或外祖父母为HBV感染者,占86.8%(369/425);57.0%(2822/4951)血清HBsAb阳性,城镇学生59.9%(985/1642)与农村学生55.5%(1837/3309)无显著性差异(P>0.05);血清HBsAb阴性者1704名,占34.4%(1704/4951)。②4526名血清HBsAg和或HBeAg阴性者进行乙肝疫苗接种1年后,2822名血清HB-sAb阳性者HBsAb仍全阳性,1704名血清HBsAb阴性者87.1%(1485/1704)血清HBsAb阳性;12.9%(219/1704)血清HBsAb仍阴性。③HBsAb阴性者接种1年后HBsAb仍阴性者219名,其中11名HBV-DNA>103copies/ml,占5.0%(11/219);52名102copies/ml<HBV-DNA≤103copies/ml,占23.7%(52/219);156名HBV-DNA≤102copies/ml,占71.3%(156/219)。结论:乙肝疫苗接种无或弱应答是个体内、外部多种因素共同作用的结果,引起乙肝疫苗接种无或弱应答的原因中,内部因素起了决定性作用,遗传因素通过决定特定的免疫应答机制也起着重要作用。

Objective：To explore the HBsAb negative impact on immunization hepatitis B vaccine after HBsAb weak or non - response factors. Methods： HBV - M Detection, by ELISA, HBV - DNA testing, using real - time quantitive PCR analysis. Results：①4951 high school students, 88.0% （ 4356/4951 ） Hepatitis B Vaccination history, urban students （ 99. 0% ） was significantly higher than that of rural students （ 82.5% ） （ P 〈 0. 01 ） ; 8.6% （ 425/4951 ） and serum HBsAg or HBsAg or HBeAg positive, of whom 369 of their parents or grandparents for HBV infection, acconting for 86. 8% （369/425） ;57.0% （2822/ 4951 ）HBsAb positive serum, urban students 59. 9% （958/1642） and 55.5% of rural students （1837/3309） there was no significant difference （P 〉 0. 05 ）;serum HBsAb negative 1704 ,aceonfing for 34. 4% （1704/4951）. ②526 seyum HBsAg and or HBseAg negative for hepatitis B vaccination in one year after the 2822 serum HBsAg negative 87. 1% （ 1445/1704 ）HBsAb positive serum; 12.9% （219/1704） serum HBsAb still negative. ③HBsAb negative one year after vaccination HBsAb still negative 219,of which 11 HBV - DNA 〉 103 copies/ml, acconting for 5.0% （ 11/219 ）. 52 103 copies/ml 〈 HBV - DNA ≤ 10^3 copies/ml, acconting for 23.7% （52/1219） ;156 HBV - DNA≤ 10^2 copies/ml,acconting for 71.3% （156/219）. Conclusion：The hepetitis B vaccination is no indvidual or weak response, a number of factors working together,the results of hepatitis B vaccine caused no or weak response of the reasons, internal factors played a decisive role, genetic factors decided by a specific immune response mechanism has also played an important role.