母体血清抗-HBs水平对婴儿乙肝疫苗接种免疫应答的影响

Effect of maternal serum anti-HBs level on infants' immune response to hepatitis B virus vaccine

目的了解母体血清抗-HBs水平是否对婴儿乙肝疫苗0-1-6个月接种方案免疫效果产生影响。方法选择2014年1月-2015年12月来滨州市人民医院儿科住院治疗且在该院足月出生,并全程按时完成乙肝疫苗0-1-6个月三针免疫接种程序的8～24月的婴幼儿109名,对婴幼儿血清抗-HBs的定量检测结果与其母住院分娩时血清抗-HBs的定量检测结果进行统计分析。结果母体血清抗-HBs<10 mIU/ml且HBs Ag阴性56例,其婴幼儿乙肝疫苗接种后无应答者6例(10.71%),有应答者50例(89.29%),血清抗-HBs水平为411.39(58.81,1 435.81)mIU/ml;母体血清抗-HBs≥10mIU/ml 53例,其婴幼儿乙肝疫苗接种后无应答者1例(1.89%),有应答者52例(98.11%),其血清抗-HBs水平为457.11(114.54,1 475.49)mIU/ml,母体抗-HBs水平对两组婴幼儿乙肝疫苗免疫应答率差异无统计学意义(χ~2=3.618,P=0.308),两组婴幼儿乙肝疫苗接种后血清抗-HBs水平差异无统计学意义(Z=-0.485,P=0.628);不论母体血清抗-HBs<10 mIU/ml还是≥10 mIU/ml,16～24月龄婴幼儿血清抗-HBs水平均较8～16月龄下降,两者比较差异均有统计学意义(Z=-4.437、-3.742,均P=0.000),而同一月龄段(不论是8～16月龄段间还是16～24月龄间)婴幼儿血清抗-HBs水平差异均无统计学意义(Z=-0.496、-0.881,P=0.620、0.378);对于母体血清抗-HBs≥10 mIU/ml者,其婴幼儿血清抗-HBs水平与母体抗-HBs水平无相关性(r=-0.046,P=0.746)。结论母体血清抗-HBs水平对婴儿乙肝疫苗0-1-6个月接种方案免疫效果不产生影响。

Objective To investigate the effect of maternal serum hepatitis B virus surface antibody （anti-HBs） level on the immune response of their infants towards hepatitis B vaccine. Methods One hundred and nine infants aged 8-24 months injected with hepatitis B vaccine according to the standard immnunization program and hospitalized and born full-term in the Department of Pediatrics of Binzhou People＇ s Hospital from January 2014 to December 2015 were enrolled in this study. The quantitative detection results of the anti-HBs concentration in sera of the infants and mothers were analyzed. Results Among the 56 infants with maternal anti-HBs 〈 10 mIU/ml and negative HBsAg, 6 infants （10.71%） did not have immune response after injection of hepatitis B vaccine, and 50 （89.29%） had, with the median （95%CI） of serum anti-HBs level of 411.39 mIU/ml（ 58.81 mIU/ ml, 1,435.81 mIU/ml） . Among the 53 infants with maternal anti-HBs≥ 10 mIU/ml, 1 infant （ 1.89% ） did not have immune response, and 52 （ 98.11% ） had, with the median （ 95% CI） of serum anti-HBs level of 457.11 mIU/ml { 114.54 mIU/ml, 1,475.49 mlU/ml）. No statistically significant difference was found in the infants＇ immune response rate to hepatitis B vaccine （χ^2= 3.618, P=0.308） as well as in the serum anti-HBs level （Z=-0.485, P= 0.628） between the two infant groups with different levels of maternal anti-HBs. Whichever the serum level of maternal anti-HBs was （ 〈 10 mIU/ml or ≥ 10 mIU/ml） , the serum level of anti -HBs was significantly lower in infants aged 16-24 months than in those aged 8-16 months （Z =-4. 437, Z =- 3.742, both P = 0. 000）. But no statistically significant difference was found in the serum anti-HBs level among infants aged 8-16 months （Z= -0.496, P = 0.620 ） as well as among infants aged 16-24 months （Z =-0. 881, P = 0.378） between the two maternal groups. As for infants with the serum maternal anti-HBs ≥ 10 mIU/ml, there was no correlation in the serum anti-HBs level between infants and mothers （r=-0.046, P=0.746）. Conclusion The maternal serum anti-HBs level has no effects on the immune response of infants injected with hepatitis B vaccine according to the standard immunization program.