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目的了解在青少年中不同剂量重组乙型肝炎疫苗(CHO细胞)采用两针或三针免疫接种程序接种后,乙肝病毒表面抗体的应答,为制定青少年乙肝疫苗免疫策略提供依据。方法将岳阳市湘阴县246名11~15岁学生随机分为四组,采用10μg(CHO细胞)和20μg(CHO细胞)乙肝疫苗按照0、3或0、1、6两种不同的免疫程序进行接种,首针免疫后的第7个月检测血清抗-HBs阳转率和抗-HBs平均几何滴度(GMT),同时观察不良反应。结果 10μg,0、3接种组(Ⅰ组)、10μg,0、1、6接种组(Ⅱ组)、20μg,0、1、6接种组(Ⅲ组)、20μg,0、3接种组(Ⅳ组)抗-HBs阳转率分别为71.9%、94.8%、94.1%和96.8%,Ⅱ、Ⅲ、Ⅳ组抗-HBs阳转率显著高于Ⅰ组(P<0.05);血清抗-HBs平均几何滴度(GMT),Ⅰ、Ⅱ组显著低于Ⅲ、Ⅳ组(P<0.05),而Ⅲ、Ⅳ组之间比较差异无统计学意义(P>0.05)。结论在青少年(11~15岁)人群中,采用20μg大剂量的乙肝疫苗接种后能获得较高抗体阳转率和平均几何滴度,且两针法能达到三针法同样的效果,完全可能取代低剂量三针接种,达到一样的免疫效果,值得推广。
Objective To understand the response of hepatitis B virus surface antibody to different doses of recombinant hepatitis B vaccine (CHO cells) in adolescents after vaccination with two or three doses of vaccination program, so as to provide the basis for formulating the immunization strategy of adolescent hepatitis B vaccine. Methods A total of 246 students aged 11 to 15 in Xiangyin County of Yueyang City were randomly divided into four groups. Two different immunization programs of 0, 3 or 0, 1, 6 were administered with 10μg (CHO cells) and 20μg (CHO cells) Inoculation was carried out. Serum anti-HBs positive rate and anti-HBs geometric mean titers (GMTs) were measured at the 7th month after the first immunization. Adverse reactions were also observed. Results 10μg, 0,3 vaccinated group (group Ⅰ), 10μg, 0,1,6 vaccinated group (Ⅱ group), 20μg, 0,1,6 vaccinated group (Ⅲ group), 20μg, 0,3 vaccinated group Group, the positive rate of anti-HBs was 71.9%, 94.8%, 94.1% and 96.8%, respectively. The positive rate of anti-HBs in group Ⅱ, Ⅲ and Ⅳ was significantly higher than that in group Ⅰ The geometric titers (GMT) of group Ⅰ and Ⅱ were significantly lower than those of group Ⅲ and Ⅳ (P <0.05), but there was no significant difference between group Ⅲ and group Ⅳ (P> 0.05). Conclusion In adolescents (11 to 15 years old), 20μg high-dose hepatitis B vaccination can achieve high antibody positive conversion rate and average geometric titers, and the two-stitch method can achieve the same effect of three stitches method, it is entirely possible Replace the low-dose three-needle inoculation, to achieve the same immune effect, it is worth promoting.