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目的了解盐城市1~7岁儿童乙型肝炎(乙肝)病毒表面抗原(HBsAg)阳性率和乙肝病毒表面抗体(抗-HBs)水平,评估实施乙肝疫苗免疫以来保护效果。方法采用多阶段分层整群抽样方法,对1998~2004年出生的儿童进行HBsAg阳性率和抗-HBs水平测定,并对其中的阴性对象进行加强免疫。结果调查1~7岁儿童2 477人,HBsAg阳性率为0.61%,抗-HBs阳性率为62.4%,各年龄组之间的抗-HBs阳性率和几何平均浓度(GMC)有明显的差异,即随着年龄的增长,抗-HBs阳性率和GMC逐渐下降。对310名抗-HBs阴性对象分别采用重组乙肝疫苗[中国仓鼠卵巢细胞(CHO细胞)]10μg、20μg和重组乙肝疫苗(酵母)5μg、10μg进行加强免疫,结果显示:重组乙肝疫苗(CHO细胞)20μg组抗-HBs阳性率和GMC最高,分别为96.3%和301.65mIU/ml;重组乙肝疫苗(酵母)5μg的抗-HBs阳性率和GMC最低,分别为90.7%和203.10mIU/ml。结论盐城市1~7岁儿童HBsAg阳性率显著低于全国平均水平,随着年龄的增长,抗-HBs阳性率和GMC逐渐下降,3岁儿童的抗-HBs阳性率下降至56.6%,有必要对5μg重组乙肝疫苗(酵母)在儿童中的应用效果进行进一步研究,考虑在适当年龄采用10μg以上的重组乙肝疫苗(CHO细胞或酵母)予以加强免疫。
Objective To understand the positive rate of hepatitis B virus surface antigen (HBsAg) and the level of hepatitis B virus surface antigen (anti-HBs) in children aged 1 ~ 7 years in Yancheng, and to evaluate the protective effect of hepatitis B vaccine after immunization. Methods The multi-stage stratified cluster sampling method was used to measure the HBsAg positive rate and anti-HBs level in children born from 1998 to 2004, and the negative subjects were boosted. Results A total of 2 477 children aged 1 to 7 years were investigated. The positive rate of HBsAg was 0.61% and the positive rate of anti-HBs was 62.4%. The positive rate of anti-HBs and the geometric mean concentration (GMC) Namely with age, anti-HBs positive rate and GMC decreased gradually. 310 anti-HBs negative subjects were boosted with recombinant hepatitis B vaccine [Chinese hamster ovary cells (CHO cells)] 10μg, 20μg and recombinant hepatitis B vaccine (yeast) 5μg, 10μg respectively. The results showed that recombinant hepatitis B vaccine (CHO cells) The positive rate of anti-HBs and the highest GMC of 20μg group were 96.3% and 301.65mIU / ml, respectively. The positive rate of anti-HBs and the lowest GMC of 5μg recombinant hepatitis B vaccine were 90.7% and 203.10mIU / ml, respectively. Conclusion The positive rate of HBsAg in children aged 1 to 7 years in Yancheng was significantly lower than the national average. With the increase of age, the positive rate of anti-HBs and GMC gradually decreased, and the positive rate of anti-HBs in 3-year-old children dropped to 56.6% The effect of 5 μg of recombinant hepatitis B vaccine (yeast) on children was further studied, considering the use of 10 μg or more of recombinant hepatitis B vaccine (CHO cells or yeast) at the appropriate age for boosting.