成年人接种乙肝疫苗后无(弱)应答状况及其影响因素分析

Study on the status and influencing factors of non-and low-response to HB vaccine in adults

目的探讨成年人接种乙型肝炎疫苗后无(弱)应答的发生率及其影响因素。方法采用整群随机抽样法调查1 256名接种过乙肝疫苗的工人,采用统一的方法进行问卷调查和免疫学检测。应用非条件Logistic回归对无(弱)应答的影响因素进行分析。结果乙型肝炎疫苗无(弱)应答率为12.98%。无(弱)应答率随年龄增高逐渐上升。单因素Logistic回归分析结果表明,接种者的年龄、接种部位、吸烟、饮酒、喜欢吃鱼、输过血制品、餐具不消毒、母亲接种过疫苗、父母亲接种乙肝疫苗后有无抗体产生等因素与接种乙肝疫苗后无(弱)应答的发生有关。多因素Logistic回归分析发现,接种时年龄大(OR=1.493 6,95%CI:1.278 6～1.744 8)、接种部位(OR=1.265 5,95%CI:1.107 2～1.446 5)、吸烟(OR=1.307 6,95%CI:1.073 1～1.593 5)、餐具不消毒(OR=1.471 5,95%CI:1.010 6～2.142 6)、父亲接种后无抗体产生(OR=1.338 5,95%CI:1.113 5～1.609 1)、母亲接种后无抗体产生(OR=1.307 9,95%CI:1.125 1～1.520 3)为无(弱)应答的危险因素,喜欢吃鱼(OR=0.628 1,95%CI:0.425 6～0.926 8)为保护因素。结论接种乙肝疫苗后无(弱)应答状况与接种因素、饮食因素、机体发育因素、遗传因素和卫生行为习惯有关。

Objective To study the status of non-and low-response to hepatitis B（HB） vaccine and its influencing factors in adults.Methods Cluster random sampling was carried out.1 256 workers inoculated with HB vaccine were chosen randomly,and standard methods were used for questionnaire investigation and immunoassay.Non-condition Logistic regression analysis was used to analyze the reason of non-and hypo-responders with HB vaccine.Results The frequency of non-and low-response was 12.98% in adults,and it was positively associated with age.Univariate Logistic regression analysis indicated that the influencing factors of non– and low-response were age,vaccination site,smoking,alcohol drinking,like eating fish,input medicine made by blood,dishware having not been sterilized,mother with vaccination and anti-production of parent with vaccination.Multivariate Logistic regression analysis showed that age（OR=1.493 6,95% CI：1.278 6～1.744 8）,vaccination site（OR=1.265 5,95% CI：1.107 2～1.446 5）,smoking（OR=1.307 6,95% CI：1.073 1～1.593 5）,father without antibody production with vaccination（OR=1.338 5,95% CI：1.113 5～1.609 1） and mother without antibody production with vaccination（OR=1.307 9,95% CI：1.125 1～1.520 3） were risk factors,while eating fish（OR=0.628 1,95% CI：0.425 6～0.926 8） might be the protective factor.Conclusions The influencing factors of non-and low-response were vaccination,foods,individual,heredity factors and healthy behavior.