接种乙肝疫苗对老年维持性血液透析患者乙肝表面抗体产生的影响

Effect of hepatitis B vaccination on the production of anti-HBs in elderly patients undergoing maintenance hemodialysis

目的探讨免疫接种乙肝疫苗对老年维持性血液透析(MHD)患者体内乙肝表面抗体(抗-HBs)产生的影响。方法 75例老年MHD患者(≥65岁)随机分为两组:试验组39例,分别在第0、1、6、9个月肌肉注射重组乙肝疫苗20μg;对照组36例,不注射乙肝疫苗及乙肝免疫球蛋白。1年后采集血样,测定乙肝两对半及抗-HBs滴度(>10mIU/ml为阳性)。结果1年后,试验组抗-HBs阳转率和滴度均高于对照组[38.46%vs.8.33%和(298.90±190.87)mIU/ml vs.(170.56±118.98)mIU/ml](P<0.05)。试验组无HBsAg转阳患者,对照组1例患者HBsAg转阳。结论接种乙肝疫苗能促使老年MHD患者体内产生抗-HBs,降低HBV感染的风险。

Objective To investigate the effect of hepatitis B vaccination on the production of antibody to HBsAg（anti-HBs）in elderly patients undergoing maintenance hemodialysis（MHD）.Methods A total of 75 MHD patients（aged≥65 years old）was randomized into two groups.Group A（39 cases）received a total of 4 vaccinations using intramuscular injection of recombinant hepatitis B vaccine 20μg in 0 th,1 st,6 th and 9 th month,respectively.Group B（36 cases）did not receive any vaccination as the control.The markers of HBV and anti-HBs titer were tested one year after the first vaccination.Anti-HBs titer10 mIU/ml was defined as positive.Results The positive ratios of antiHBs and anti-HBs titer in group A were higher than those in group B one year after the first vaccination[38.46% vs.8.33% and（298.90±190.87）mIU/ml vs.（170.56±118.98）mIU/ml]（P〈0.05）.All the patients in group A were HBsAg negative and one patient in group B was HBsAg positive.Conclusion Hepatitis B vaccination is able to promote elderly MHD patients to produce antiHBs and decrease the risk for HBV infection.