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目的评价儿童乙型肝炎(乙肝)疫苗(HepB)免疫后保护性抗体应答水平及乙肝病毒表面抗体(抗-HBs)阴性儿童加强免疫后抗体的变化。方法采取多阶段整群系统抽样方法抽取调查单位和儿童,用固相放射免疫方法检测接种儿童血清乙肝病毒表面抗原(HBsAg)、抗-HBs和乙肝病毒核心抗体水平,并对抗-HBs阴性儿童进行加强免疫。结果3~12岁儿童抗-HBs平均阳性率为49.3%,几何平均浓度(GMC)为70.22毫国际单位/毫升(mIU/ml)。重组乙肝疫苗(酵母)免疫后3~6岁儿童抗-HBs阳性率为37.6%,随年龄增长而下降,GMC为55.29mIU/ml,各年龄组差异有非常显著的统计学意义。6~12岁儿童使用血源HepB,抗-HBs阳性率为51.0%,GMC为68.27mIU/ml,各年龄组差异无显著的统计学意义。抗-HBs阴性儿童加强免疫后抗体阳转率为93.9%,GMC为91.83mIU/ml。结论儿童HepB免疫后12年保护性抗体应答良好,HBsAg阳性率未随免疫时间延长而增加,目前尚不需进行加强免疫。抗-HBs阴性儿童加强免疫后有很好的回忆反应。
Objective To evaluate the level of protective antibody response after HepB immunization in children and the antibody changes after booster immunization in children with hepatitis B virus surface antigen (anti-HBs). Methods A multistage cluster sampling method was used to select the investigation units and children. The levels of serum HBsAg, anti-HBs and hepatitis B virus (HBV) were measured by solid-phase radioimmunoassay in children and anti-HBs negative children Strengthen immunity. Results The average positive rate of anti-HBs in children aged 3 to 12 years was 49.3%, and the geometric mean concentration (GMC) was 70.22 milliunits International Unit / ml (mIU / ml). The positive rate of anti-HBs in children aged 3 ~ 6 years after immunization with recombinant hepatitis B vaccine was 37.6%, and decreased with age. The GMC was 55.29mIU / ml, and the difference was statistically significant in all age groups. HepB was used in 6-12-year-old children. The positive rate of anti-HBs was 51.0% and the GMC was 68.27mIU / ml. No significant difference was found in all age groups. Anti-HBs-negative children after boosting antibody positive rate of 93.9% positive, GMC was 91.83mIU / ml. Conclusions The protective antibody response to HepB in children after 12 years of immunization is good, and the positive rate of HBsAg is not increased with the prolongation of immunization. So far there is no need of booster immunization. Anti-HBs negative children have a good memory response after booster immunization.