论文部分内容阅读
为了探索新生儿乙型肝炎 (乙肝 )疫苗全程免疫后 ,乙肝病毒表面抗体 (抗 HBs)低应答者的再免疫方法 ,于2 0 0 0年 10月～ 2 0 0 2年 11月 ,将乙肝疫苗全程免疫 (10 μg× 3)后抗 HBs和乙肝病毒表面抗原 (HBsAg)均阴性的171名婴儿随机分成 6组 ,除设立 1组对照外 ,其余 5组分别采用不同的再免疫方法 :A组 ,增加接种次数 ,再接种 3针 ;B组 ,接种剂量加倍 ,再接种 3针 ;C组 ,改变接种途径 ,改为皮内接种 3针 ;D组 ,接种疫苗与A组相同 ,但同时联合应用免疫调节剂 1个疗程 ;E组 ,更换疫苗种类 ,改用重组 (CHO细胞 )乙肝疫苗。 5组均按 0、1、2个月程序接种。结果显示 :抗 HBs总阳转率为 89 0 4 % ,抗 HBs几何平均滴度 (GMT)为 5 90 38mIU/ml。A、B、C、D、E组抗 HBs阳转率分别为 87 5 0 %、90 91%、6 0 0 0 %、10 0 0 0 %、96 77% ;各组GMT分别为 6 0 4 82mIU/ml、770 4 6mIU/ml、372 4 5mIU/ml、6 5 1 70mIU/ml、5 0 8 6 6mIU/ml。第 1、2、3针再免疫后的抗 HBs阳转率分别为 5 9 79%、84 71%、89 0 4 % ;GMT分别为 12 2 71mIU/ml、35 4 70mIU/ml、5 90 38mIU/ml。表明乙肝疫苗初次免疫失败的婴儿 ,再免疫的效果是肯定的。相对而言 ,以联合应用免疫调节剂或更换乙肝疫苗种类更为理想 ,再免?
In order to explore the newborn hepatitis B (hepatitis B) vaccine after full immunity, hepatitis B virus surface antibody (anti-HBs) low responders re-immunization methods, from October 2000 to November 2002, the hepatitis B A total of 171 infants with negative HBsAg and HBsAg after immunization (10 μg × 3) were randomly divided into 6 groups. In addition to the establishment of a group of control, the remaining 5 groups were re-immunized with different methods: A Group B, the number of inoculation was increased and then inoculated with 3 needles; in group B, the inoculation dose was doubled and then inoculated with 3 needles; in group C, the route of inoculation was changed to 3 inoculation in skin; group D, vaccination was the same as in group A, Combination of immunomodulatory agents a course of treatment; E group, change the vaccine species, switch to recombinant (CHO cells) hepatitis B vaccine. 5 groups were vaccinated according to 0,1,2 months. The results showed that the total positive conversion rate of anti-HBs was 89 0 4%, and the geometric mean anti-HBs titer (GMT) was 5 90 38 mIU / ml. The positive rates of anti-HBs in group A, B, C, D and E were 87 5 0%, 90 91%, 60 0%, 100 0% and 96 77%, respectively; 82mIU / ml, 770 4 6mIU / ml, 372 4 5mIU / ml, 6 5 1 70mIU / ml, 5086 6mIU / ml. The positive rates of anti-HBs after re-immunization were 59 79%, 84 71% and 89 0 4% respectively at the 1st, 2nd, 3rd refections. The GMTs were 12 2 71 mIU / ml, 35 4 70 mIU / ml and 5 90 38 mIU / ml. The effect of re-immunization was positive for infants who showed initial immunization of hepatitis B vaccine failed. Relatively speaking, the combination of immunomodulators or hepatitis B vaccine replacement is more ideal, and then avoid?