北京市顺义区乙型肝炎疫苗母婴阻断效果评价

Analysis on the Effects of Hepatitis B Vaccine to Prevent Mother-to-Children Transmission of Hepatitis B Virus in Shunyi District of Beijing Municipal

目的评价北京市顺义区现行乙型肝炎(乙肝)疫苗(Hepatitis B Vaccine,HepB)免疫策略的母婴阻断效果。方法利用2005～2008年乙肝病毒表面抗原[Hepatitis B Virus(HBV)Surface Antigen,HBsAg]单阳性母亲、HBsAg和乙肝病毒e抗原(HBV e Antigen,HBeAg)双阳性母亲所生儿童,HepB免疫后的血清学监测资料,分析其血清HBsAg、抗乙肝病毒表面抗原抗体(Anti-HBsAg Antibody,Anti-HBs)和抗乙肝病毒核心抗原杭体[Anti-HBVCore Antigen(HBcAg)Antibody,Anti-HBc]水平以及疫苗保护水平。结果所监测的223名儿童中,总体HBsAg阳性率为2.69%,HepB保护率为96.83%。母亲HBsAg、HBeAg双阳性的儿童,其HBV感染率为7.55%,显著高于母亲HBsAg单阳性者(1.18%)。总体Anti-HBs阳性率为82.96%,各年份Anti-HBs阳性率差异有统计学意义;抗体几何平均浓度(Geometric Mean Concentration,GMC)为139.32mIU/ml(毫国际单位/毫升),2007、2008年抗体GMC明显高于2005、2006年;采用乙肝免疫球蛋白(Hepatitis B Immunoglobulin,HBIG)联合免疫的儿童,抗体GMC明显高于未使用HBIG者。结论北京市顺义区现行HepB免疫策略,对母亲HBsAg阳性的儿童的保护效果比较理想。

Objective To evaluate the effects of immunization strategy about Hepatitis B vaccine preventing mother-to-children transmission（MTCT）of Hepatitis B virus（HBV）in Shun Yi District of Beijing.Methods The supervision data of blood serum of the children born from mothers who HBsAg carrier or HBsAg and HBeAg carrier were collected during the years of 2005～2008.The positive rate of HBsAg,anti-HBs,anti-HBc and the protective rate were analyzed.Results 223 children born from mothers of HBsAg and HBeAg carrier or HBsAg carrier were vaccinated according to the Hepatitis B vaccine immunigation strategy of Beijing.The infective rate of HBV was 1.18%, and protective rate of HepB was 98.61%.The infective rate of HBV of the children born from mothers of HBsAg and HBeAg carrier was higher than the rate of the children born from mothers of HBsAg carrier. The positive rate of anti-HBs was 84.71%.There were statistics significance in different years.The GMC of anti-HBs was 139.32 mIU per mL.The anti-HBs GMC of 2007 and 2008 were higher than those of 2005 and 2006.The anti-HBs GMC of the children who HBIG adopted was higher than that of the children who HBIG did not adopted.Conclusion The Hepatitis B vaccine immunization strategy of Shun Yi District had good immunological and protective effects to prevent HBV perinatal transmission.