5985名学生乙肝疫苗接种后免疫效果分析

Analysis of immunization effect in 5 895 students after vaccinated with hepatitis B vaccine

目的探讨中小学生乙肝疫苗接种后免疫应答状况,为制定有效的乙肝预防措施提供科学依据。方法应用ELISA法测定中、小学生血清三项乙肝感染标志(HBsAg、HBeAg、HBeAb),对三项标志全阴性者再应用时间分辨荧光免疫分析法(TRFIA)测定血清二项感染标志(HBsAb、HBcAb)。结果血清三项感染标志(HBsAg、HBeAg、HBeAb)全阴性者其HBsAb阳性率为81.27%,中学生阳性率为80.27%,小学生阳性率为82.50%,差异有统计学意义(χ2=4.82,P<0.05)。HBsAb有应答者HBcAb阳性率为5.12%,中学生阳性率为8.82%,小学生阳性率为0.68%,差异有非常显著性(χ2=164.58,P<0.01)。HBsAb无应答者HBcAb阳性率为21.14%,中学生阳性率为19.73%,小学生阳性率为7.68%,差异有非常显著性(χ2=87.70,P<0.01)。HBsAb有应答者和HBsAb无应答者其HBcAb阳性率差异有非常显著性(χ2=313.48,P<0.01)。结论该地区学生HBsAb阳性率较低,免疫效果不理想,小学生HBsAb阳性率较高,中学生HBcAb阳性率较高,提示学生中乙肝疫苗接种需加强和改进。

Objective To evaluate the immunization effect in students after 3 doses HepB immunization.Methods The serum samples from study objects were tested with ELISA assay for HBV 3 infection markers（HBsAg,HBeAg and HBeAb）,the sample that was negative in 3 markers further was tested with time-resolved fluoroimmunometric assay（TRFIA） for HBV 2 infection markers（HBsAb、HBcAb）.Result The positive rates of HBsAb of the study objects that was negative in markers（HBsAg、HBeAg、HBeAb） was 81.27%,and the positive rates of HBsAb among middle school students and pupils were 80.27%,82.5%,respectively,and they showed significant difference（χ2=4.82,P0.05）.The positive rates of HBcAb among the response students and non-response students were 5.12%,21.14%,respectively,and they showed significant difference（χ2=313.48,P0.001）.The positive rates of HBcAb among middle school students and pupils that had response were 8.82%,0.68%,respectively,and they showed significant difference（χ2=164.58,P0.001）,the positive rates of HBcAb among middle school students and pupils that had non-response were 19.73%,7.68%,respectively,and they showed significant difference（χ2=87.70,P0.001）.Conclusion The positive rate of HBsAb was proved to be low among the students in this area,immunological effects of Hepatitis B vaccine were not execelent,the positive rates of HBsAb was higher among pupils,that of HBcAb was higher among middle school students,it indicated that the HBV prevention of students need to be enforced and improved.