乙型肝炎病毒疫苗联合应用乙肝高效价 免疫球蛋白对乙肝免疫效果的观察

THE COMPARISON IN EFFICACY BETWEEN SINGLE USEOF HBV VACCINE OF DIFFERENT DOSAGES AND COMBINEDUSE OF HBV VACCINE AND HBIG OF DIFFERENT DOSAGES

将母亲乙型肝炎表面抗原(HBsAg)阳性的223名新生儿分成4组,分别接种乙肝疫苗上10μg(Ⅰ组)、20μg(Ⅱ组)、20μg加乙肝高效价免疫球蛋白(HBIG)1支(Ⅲ组)、20μg加HBIG2支(Ⅳ组)。随访至12个月时,抗HBs阳转率在Ⅰ、Ⅱ、Ⅲ、Ⅳ组分别为62.5％、76.8％、80.9％和84.3％:HBsAg慢性携带率各为12.5％、11.0％、4.3％和2.9％。母亲HBeAg阳性和HBsAg≥1.256者,其婴儿抗HBs阳转率低于对照组。母亲HBeAg阳性者的婴儿,易发展成HBsAg慢性携带者。

Two hundred and twenty three infants born to HBsAg positive mothers were divided Into 4 groups. Infanta in group 1 and 2 received 3 doses (10μg/dose for group 1 and 20μg/doSe for group 2) of HBV vaccine intramuscularly within 24 hours, at 1 month and 6 months of birth, respectively. To infants in group 3, 1 dose(280 IU)of HBIG was added at birth, followed by another dose at 2 weeks, or 2 doses of HBIG at birth. In addition, the latter two groups also received 3 more doses of HBV vaccine at 1 month, 2 months and 7 months of age. All the infants ware followed up to 12 months, it was found that anti-HBs conversion(>10miu/ ml considered positive)rate in group 1, 2, 3 and 4 were 62.5%, 76.8%, 80.9% and 84.3%, respectively. The incidence of HBsAg carrier infants was 12.5%, 11.0%, 4.3% and 2.9% in the 4 groups respectively. If the mothers' were HBeAg positive or HBsAg titers higher than 1:256, their infants' anti-HBs conversion rate was apparently lowered. The danger of becoming chronic HBsAg carriers will greatly increase for those infants whose mothers are HBeAg positive.