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目的评价濮阳市区新生儿基因工程乙型肝炎(乙肝)疫苗的免疫效果。方法对2010年1月-2011年12月使用基因工程乙肝疫苗,2642例在濮阳市妇幼保健院出生的新生儿出生后24h内常规接种基因乙肝疫苗,按0、1、6进行全程免疫,抽检了500名儿童分为5个观察组,对HBsAb的保护效果进行监测。结果 HBsAb的保护效果在全程免疫后,2年内保护效果最好,第1年达到96%,第2年达82%,第3年达到45%,第4年32%,第5年15%,HBsAb滴度(GMT)由第1年的123.34逐渐降至第5年的20.50,下降明显。对全程免疫后5年检测500例小儿血HBsAg无一例阳性,较接种乙肝疫苗前(1985-1991年)的7.95%有明显下降。结论在新生儿期使用基因工程乙肝疫苗进行主动免疫,第1年内HBsAb阳性率达95%以上,免疫能够安全有效地阻止乙肝传播,且有着乙肝血源疫苗所不能替代的巨大优越性,使基因工程疫苗取代血源疫苗已成定局。在免疫后3～5年进行加强免疫,使HBsAb保护性抗体水平上升,已达到保护效果。
Objective To evaluate the immunogenicity of Hepatitis B (HBV) vaccine in neonatal genetic engineering in Puyang City. Methods The genetically engineered hepatitis B vaccine was administered from January 2010 to December 2011, and 2642 newborns born in Puyang City MCH hospital were routinely inoculated with hepatitis B vaccine within 24 hours after birth. Five hundred children were divided into five observation groups to monitor the protective effect of HBsAb. Results The protective effect of HBsAb was best after 2 years of immunization, reaching 96% in the first year, 82% in the second year, 45% in the third year, 32% in the fourth year, 15% in the fifth year, HBsAb titer (GMT) decreased from 123.34 in the first year to 20.50 in the fifth year, which was obviously decreased. None of the 500 cases of HBsAg was detected positive in the 5 years after the whole immunization, which was significantly lower than 7.95% before the hepatitis B vaccine (1985-1991). Conclusion In the neonatal period, hepatitis B vaccine is used for active immunization. In the first year, the positive rate of HBsAb is more than 95%. Immunization can stop the transmission of hepatitis B safely and effectively, and has the great advantage that hepatitis B vaccine can not be replaced. It is a foregone conclusion that engineering vaccine replaces blood-borne vaccine. 3 to 5 years after immunization to strengthen the immune system, so that the level of HBsAb protective antibodies increased, has reached the protective effect.