婴幼儿乙肝免疫效果影响因素探讨

Influencing factors of hepatitis B immunization in infants and children

目的:探讨婴幼儿乙肝免疫效果的影响因素。方法:采用1∶1匹配的病例对照研究,匹配条件为性别、年龄、当前研究因素以外的其它研究因素。将2006年至2015年出生,符合入选标准的所有乙肝免疫失败的928例儿童全部纳入免疫失败组;在乙肝免疫成功且符合入选标准的2.43万名儿童中按照性别、年龄、当前研究因素以外的其它研究因素进行匹配,采用分层随机抽样的方法,抽取与病例组相同数量的儿童分别纳入对照1-5组,分析乙肝接种效果的影响因素。结果:出生体重偏离、母乳喂养情况、上呼吸道感染情况、乙肝首针接种及时性病例组与对照组间存在统计学意义(P<0.05),婴幼儿乙肝免疫失败与上述因素暴露在95%CI水平有统计学显著性,存在关联。结论:出生体重偏离、母乳喂养情况、上呼吸道感染情况、乙肝首针接种及时性影响婴幼儿乙肝免疫效果的重要因素。

Objective To explore the influencing factors of hepatitis B immune response in infants and young children.Methods A 1∶1 matching case-control study was performed with matching conditions other than those of gender,age and current research factors.All of the 928 children born from 2006 to 2015 who failed to be immunized in hepatitis B and who met the inclusion criteria were all included in the immunological failure group.A total of 24,300 children with successful hepatitis B immunization who met the inclusion criteria were matched according to the research factors other than gender,age,and current study factors.The stratified random sampling method was used to select the same number of children as those in the case group and to include them into the control group 1 to 5,and the influencing factors of hepatitis B vaccination effect were analyzed.Results There were statistically significant differences in the birth weight deviation,breastfeeding status,upper respiratory tract infection,the timely hepatitis B first dose inoculation between case group and control group（P〈0.05）.There was a correlation between failure of hepatitis B immunization in infants and children and the above mentioned factors.Conclusions Birth weight deviation,breastfeeding,upper respiratory tract infection and timeliness of hepatitis B first dose inoculation are important factors which affect the hepatitis B immunization in infants and children.