摘要
为了观察新生儿乙型肝炎 (乙肝 )疫苗免疫后长期的预防保护效果及加强免疫后的免疫应答状况和特点 ,在乙肝疫苗试点区 ,每隔 1～ 2年 ,采取整群随机抽样方法对 1985～ 1988年出生的新生儿接种乙肝疫苗后的效果随访 1次 ,随访 15年 ,共观察 5 0 0 6人。将血源乙肝疫苗免疫后 9～ 11年的 170名儿童分为 3组 ,用重组 (酵母 )乙肝疫苗分别进行 1～ 3剂次的加强免疫 ,每剂次 5 μg ,然后采血用固相放射免疫法检测乙肝病毒表面抗原 (HBsAg)和抗体 (抗 -HBs)。结果显示 :新生儿血源乙肝疫苗全程免疫后抗 -HBs阳性率为 92 83%,几何平均滴度 (GMT)为2 0 0 91;而至 14～ 15岁时分别下降为 45 .31%和 2 7.95 %,说明 15年后约有 5 5 %的儿童抗 -HBs在保护性水平以下 (<10mIU/ml) ,而HBsAg阳性率为 1.38%,与全程免疫后 1年相比差异无显著的统计学意义。加强免疫后 1年 ,3个不同剂次加强免疫组的抗 -HBsGMT迅速升高 ,为原来的 6～ 18倍 ;抗 -HBs阳性率也由免疫前的 6 2 .5 %～ 6 6 .7%上升至 10 0 .0 %。但随着加强免疫时间的延长 ,抗 -HBs的GMT和阳性率逐渐下降 ,至免疫后 3年 ,1针加强免疫组抗 -HBs阳性率降至 71.2 %,2针组降至 79.2 %,而 3针组仅降至 92 .5 %。表明国产血源乙肝疫苗具有持久的预防保护效果 。
The long-term protective efficacy of hepatitis B(HB)vaccine and the immune response to boosting vaccination were observed in children who had been immunized with plasma-derived HB vaccine in infancy.5006 persons were selected by random cluster sampling method for immune persistence study,they were born in 1985～1988,whole-course vaccinated with plasma-derived HB vaccine at birth,and followed up for 15 years by once every 1～2 years. 170 children who had been immunized with plasma-derived HB vaccine 9～11 years ago were divided into three groups,receiving yeast-derived HB vaccine 1,2,3 doses(5μg/dose)respectively. Their blood samples were tested for HBsAg and anti-HBs by RIA.The results showed that, in newborns,after whole-course immunized with plasma-derived HB vaccine,the anti-HBs positive rate and the GMT were 92.83% and 200.91+3.43 respectively,but decreased to 45.31% and 27.95+1.85 14～15 years later,indicating that the protective level of anti-HBs was under 10 mIU/ml in 55% of the children.The HBsAg, during this time, was 1.38%,it had no significant difference compared with that appeared 1 year after infancy vaccination.Three groups of boosting vaccination showed a rapid increasing of anti-HBs and GMT one year later,the GMT raised by 6～18 times,the positive rate of anti-HBs raised from 62.5%～66.7% to 100%.After three years of boosting ,the anti-HBs positive rate and GMT gradually decreased, GMT decreased 3～4 folds, the posi-tive rate of 1-dose boosting group was 71.2%,2-dose boosting group 79.2%.and 3-dose boosting group was 92.5%.The study indicated that the domestic blood-derived HB vaccine possessed persistent protective efficacy and good immune memory response,the effect of boosting inoculation was closely related with booster times and the immune status prior boosting.If necessary,the 3-dose boosting injections of yeast-derived HB vaccine can be considered to take during universal HB vaccination to newborns,especially to children with very low antibody level after primary vaccination.
出处
《中国计划免疫》
2002年第4期185-188,共4页
Chinese Journal of Vaccines and Immunization
关键词
新生儿
乙型肝炎疫苗
加强免疫
免疫应答
Hepatitis B vaccine,Boost inoculation,Anti-HBs,Immune response
