急性淋巴细胞白血病患者乙型肝炎疫苗免疫效果的meta分析

Meta-analysis of the immune effect of hepatitis B vaccineinacute lymphoblastic leukemia patients

目的 系统评价急性淋巴细胞白血病(ALL)患者接种乙型肝炎疫苗的免疫效果,为该人群乙型肝炎防控及疫苗接种策略制定提供参考依据。方法 文献检索1989年1月-2018年2月符合本次分析要求的ALL患者乙型肝炎疫苗接种免疫效果文献,以乙型肝炎表面抗体(抗-HBs)阳转率为效果指标进行meta分析。结果 共纳入文献8篇。随机效应模型结果显示,ALL患者接种乙型肝炎疫苗的抗-HBs阳转率为0.47(95%CI:0.28~0.66)。亚组分析显示,接种3、4、5剂次乙型肝炎疫苗程序的抗-HBs阳转率分别为0.64(95%CI:0.54~0.73)、0.39(95%CI:0.04~0.83)、0.35(95%CI:0.28~0.42),且不同接种程序的抗-HBs阳转率比较差异有统计学意义(P<0.01)。结论 ALL患者接种乙型肝炎疫苗的免疫效果较好,且高剂量组乙型肝炎免疫效果高于低剂量组,应加强该人群乙型肝炎防控宣传,积极开展急性淋巴细胞白血病患者乙型肝炎疫苗免疫效果的多中心研究。

Objective Systematic evaluation of the immune effect of hepatitis B vaccine in patients with acute lymphoblastic leukemia(ALL),providing reference for the prevention and control of hepatitis B,and vaccination strategy development to this population.Methods The literature on the immune effect of hepatitis B vaccination in patients with ALL,who met the requirements of this analysis from January 1989 to February 2018,was used to evaluate the positive rate of hepatitis B surface antibody(anti-HBs)and conduct meta-analysis.Results Totally 8 articles were selected in the study.The random effects model showed that the anti-HBs positive rate of hepatitis B vaccine in all patients was 0.47(95%CI:0.28-0.66).Subgroup analysis showed that the anti-HBs positive rate of the 3,4,5 doses of hepatitis B vaccine were 0.64(95%CI:0.54-0.73),0.39(95%CI:0.04-0.83),0.35(95%CI:0.28-0.42),respectively,and there were statistically significant in anti-HBs positive rate of different vaccination programs(P0.01).Conclusion The immune effect of hepatitis B vaccine in all patients is fairly good,and the immune effect of hepatitis B vaccine in high dose group is higher than that in low dose group.The prevention and control of hepatitis B in all patients would be strengthened,and the multi-center research on the immune effect of hepatitis B vaccine in this population should be actively carried out.