婴儿接种乙型肝炎疫苗的免疫效果及低、无应答者再免疫效果探讨

EffectS of neonatal hepatitis B vaccination and its once more immune effect in low or no responders

目的：探讨婴儿接种乙型肝炎疫苗的免疫效果及低、无应答者再免疫效果。方法筛查松滋市妇幼保健院2000例7～12个月婴儿乙型肝炎疫苗初次免疫（初免）的效果，分析影响初免的因素，对初免低或无应答婴儿选择10μg汉逊酵母乙型肝炎疫苗或5μg重组酵母乙型肝炎疫苗进行再次接种（再免），分析再免1、3次后的效果。结果（1）2000例婴儿乙型肝炎疫苗初免应答率为92．2％，平均抗-HBs几何抗体浓度（GMC）为：（321．88±100．45）IU/L，其中父母HBsAg阳性和在乡镇医院出生的婴儿应答率较低，与父母HBsAg阴性和在县级以上医院出生的婴儿差异均有统计学意义（χ2＝30．61、47．58，均P＜0．05）。（2）两种疫苗再免1次、3次GMC含量均比再免前增高，差异均有统计学意义（t＝98．32、102．15，均P＜0．05）；再免3次较再免1次应答率及GMC含量高，差异均有统计学意义（t＝98．55、102．33，均P＜0．05）；汉逊酵母乙肝疫苗再免1次、3次后GMC含量较高，与重组酵母乙型肝炎疫苗差异均有统计学意义（ t＝104．11、124．31，均P＜0．05）。结论父母HBsAg阳性和在基层医院出生的婴儿低、无应答比例较高，再免后应答率较高，汉逊酵母乙型肝炎疫苗效果较好。

Objective To investigate the immune effect of neonatal hepatitis B vaccination and its once more immune effect in low or no responders .Methods Screening Songzi city MCH 2 000 cases of hepatitis B vaccine 7-12 months baby＇s first immunization effect ,analyze the impact of the prime factors for early response in children with low or no free choice 10μg Hansenula yeast recombinant hepatitis B vaccine or 5μg hepatitis B vaccine （ HepB-SC） , carried revaccination（Immune again）,then analyzed the effect of free 1,3 times.Results （1） Primary immune response rate of neonatal hepatitis B vaccine in 2 000 cases was 92.2%,the average anti-HBsGMC was （321.88 ± 100.45） IU/L,in which the HBsAg positive persons and birth in the township hospital neonatal response rate was low that had a statistically significant （χ2 =30.61,47.58,all P 〈0.05） difference with the children whose parents＇HBsAg was negative and borned in hospitals above the county level;（ 2 ） GMC content was increase in once more immune at 1,3 times than before,the difference was statistically significant （t=98.32,102.15,all P〈0.05）,and the 3 time is higher than the 1 time once more immuneof levels of GMC ,the difference was statistically significant （ t=98.55,102.33,all P〈0.05）,content of GMC is higher in once more immune of Hansenula hepatitis B vaccine at 1, 3 times when compared with the recombinant hepatitis B vaccine , the difference was statistically significant （ t =104.11,124.31,all P〈0.05）.Conclusion Low and non-responders＆#39;proportion is high in the children whose par-ents＇HBsAg is positive and be born in the primary hospital ,which has a higher response rate after once more immune , Hansenula hepatitis B vaccine has a better immune effect .