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目的研究采用不同免疫程序为成人接种20μg重组乙肝疫苗后的免疫应答效果。方法从天津城建大学2013-2014年接种的大一新生和某社区同龄接种人员各抽取650人。某社区同龄人员按013方案接种,大学生按016方案接种。013方案按照0,1,3个月免疫程序进行接种,016方案分别在0,1,6个月免疫程序进行接种,接种位置在上臂外侧三角肌。统计两种方案在第4、5、6、7月的抗体几何平均滴度水平(GMT)和阳转率。结果 013方案阳性583例,阳转率89.70%,第4、5、6和7月的GMT分别为486.96、373.15、226.38和84.20mIU/ml;016方案阳性622例,阳性率95.70%,第4、5、6和7月的GMT分别为236.62、176.32、504.62和407.91mIU/ml,016方案第6和7个月GMT水平显著高于013方案;阳转率差异具有统计学意义(χ~2=17.27,P<0.01)。013方案男性阳转率85.62%,女性86.15%,013方案性别间差异无统计学意义(χ~2=0.0420,P=0.8377);016方案男性阳转率94.74%,女性阳转率96.89%,016方案性别间差异无统计学意义(χ~2=1.7982,P=0.1799)。013方案人员共出现14例次局部反应,10例次全身反应;016方案人员共出现16例次局部反应,9例次全身反应。结论按照016方案最终的阳转率优于013方案。因而成人接种20μg重组乙肝疫苗尽量拉长第2针和第3针接种时间。
Objective To study the effect of different immunization programs on the immune response of 20 μg recombinant hepatitis B vaccine in adults. Methods Sixty-five freshmen were recruited from Tianjin Chengjian University in 2013-2014 and the same-age vaccinates in a community. The same age in a community according to the 013 program vaccination, students planted by the 016 program. 013 plan in accordance with 0, 1, 3 months vaccination program, 016 program were 0, 1, 6 months immunization program vaccination, vaccination position in the upper arm outside the deltoid. The geometric mean titer (GMT) and the positive rate of antibody in the 4th, 5th, 6th, and 7th months of the two protocols were calculated. Results There were 583 positive cases and positive conversion rates of 89.70% in the 013 cases and 486.96, 373.15, 226.38 and 84.20 mIU / ml in the 4th, 5th, 6th and 7th months respectively. The positive rate of 016 was 95%, the positive rate was 95.70% , The GMTs were 236.62,176.32,504.62 and 407.91mIU / ml in May, June, and July respectively, and the levels of GMT at the 6th and 7th month of 016 were significantly higher than those of the 013. The difference of positive conversion rate was statistically significant (χ ~ 2 = 17.27, P <0.01). The positive rates of male positive rate and positive female rate of 013 were 85.62%, 86.15% and 013% respectively (χ ~ 2 = 0.0420, P = 0.8377). The male positive rate of 016 was 94.74% and the positive rate of female was 96.89% There was no significant difference between the sexes (P> 0.05). There was no significant difference between the two sexes (χ ~ 2 = 1.7982, P = 0.1799). 013 program staff appeared in a total of 14 cases of sub-regional reactions, 10 cases of sub-systemic reactions; 016 program staff were a total of 16 sub-regional reactions, 9 cases of sub-systemic reactions. Conclusion The final positive conversion rate according to the scheme of 016 is better than that of the scheme of 013. Thus adults vaccinated 20μg recombinant hepatitis B vaccine as far as possible to extend the second and third needle inoculation time.