蒙阴县实施补种乙型肝炎疫苗项目前后学生乙型肝炎抗体水平的研究

Research on hepatitis B antibody level of students before and after catch-up immunization in Mengyin County

目的观察实施补种乙型肝炎(以下简称乙肝)疫苗项目前后疫苗应答效果,为后续学生乙肝预防方案提供依据。方法对随机抽取的甲、乙2所学校的1 364名学生,在补种乙肝疫苗项目前后,分别采用胶体金法检测指血中乙肝抗体(抗-HBs),对质控区和测试区同时出现红带判定为阳性。统计方法采用χ2检验。结果①通过实施乙肝补种项目,1 364名学生抗-HBs检出率由补种前的71.0%上升为86.6%,补种前后差异有统计学意义(χ2=99.47,P<0.01)。②学校甲在补种前抗-HBs检出率为68.6%,学校乙为76.1%,差异有统计学意义(χ2=7.65,P<0.01);补种后抗-HBs检出率基本相近,差异无统计学意义(χ2=1.71,P>0.05)。③补种前,五年级的学生抗-HBs的检出率高于七年级,分别为76.2%和63.4%,差异有统计学意义(χ2=25.97,P<0.01);补种后,五年级学生抗-HBs的检出率为89.5%,也高于七年级的82.4%,差异有统计学意义(χ2=13.98,P<0.01)。④男女学生在补种前抗-HBs检出率分别为72.8%和68.6%,差异无统计学意义(χ2=2.92,P>0.05)。补种后,男女学生的抗-HBs检出率分别87.7%和85.2%,差异无统计学意义(χ2=1.74,P>0.05)。结论①补种前后人群抗-HBs检出率对比,免疫效果非常明显,但结果偏低。②乙肝疫苗的补种应与抗-HBs的检测相结合,才能进一步提高免疫效果。建议将抗-HBs纳入中小学生健康检查项目。

[Objective] To observe the immune effect of catch-up hepatitis B vaccination,provide the foundation for hepatitis B prevention plan among students in the future.[Methods]1 364 students were randomly selected from school A and school B.Before and after catch-up hepatitis B vaccination,the hepatitis B antibody level in finger blood was detected by colloidal gold method,if red band appeared in the control area and the test area at the same time,the result was determined as positive.The statistical method was χ2 test.[Results] ① After catch-up hepatitis B vaccination,the detection rate of anti-HBs among 1 364 students rose from 71.0% to 86.6%,and there was significant difference between before and after catch-up immunization.②Before catch-up immunization,the detection rate of anti-HBs in school A and school B was 68.6% and 76.1% respectively,and the difference was significant（χ2=7.65,P0.01）.After catch-up immunization,the detection rates of two schools were similar,and the difference was not statistically significant（χ2=1.71,P0.05）.③ Before catch-up immunization,the detection rate of anti-HBs in fifth grade students（76.2%） was higher than that in seventh grade students（63.4%） significantly（χ2=25.97,P0.01）.After catch-up immunization,the detection rate in fifth grade students（89.5%） was higher than that in seventh grade students（82.4%） significantly（χ2=13.98,P0.01）.④Before catch-up immunization,the detection rate of anti-HBs in boys and girls was 72.8% and 68.6% respectively,and the difference was not significant（χ2=2.92,P0.05）.After catch-up immunization,the detection rate in boys and girls was 87.7% and 85.2% respectively,and the difference was not significant（χ2=1.74,P0.05）.[Conclusion]① The immune effect between before and after catch-up hepatitis B vaccination is significant,but the result is lower.② The catch-up hepatitis B vaccination combined with anti-HBs detection can further improve the immune effect.It is suggested that anti-HBs detection should be included into the health examination of primary and secondary school students.