【摘要】 目的了解上海市新生儿接种重组乙型肝炎(乙肝)疫苗(酵母)[Hepatitis B Vaccine Made by RecombinantDeoxyribonucleic Acid Techniques in Yeast,HepB-Y]后的低/无应答情况。方法对上海市三个区(县)2008～2009年出生的2047名新生儿,按0、1、6个月免疫程序接种HepB。采用化学发光微粒子免疫分析法检测抗乙肝病毒表面抗原抗体[Antibody to Hepatitis B Virus Surface Antigen(HBsAg),Anti-HBs],并对其家长进行问卷调查,以了解婴儿出生和疫苗接种情况。结果新生儿接种HepB后,血清Anti-HBs的几何平均浓度(Geometric Mean Concentration,GMC)为408.04毫国际单位/毫升(mIU/ml)。婴儿的低(10～99 mIU/ml)/无(<10mIU/ml)应答率为17.00%,其中无应答率为1.86%,低应答率为15.14%。13～18月龄的低/无应答率(23.03%)高于7～12月龄(6.62%)(χ2=358.518,P<0.05);接种5微克(μg)HepB(酿酒酵母)(SaccharomycesCerevisaie Yeast,HepB-SCY)婴儿的低/无应答率(21.68%)高于接种10μg HepB(汉逊酵母)(HansenulaPolymoarpha Yeast,Hep-HPY)的婴儿(3.10%)(χ2=415.024,P<0.05);早产儿的低/无应答率(31.74%)高于足月儿(16.53%)(χ2=18.140,P<0.05);孕期HBsAg阳性母亲的婴儿的无应答率(7.62%)高于HBsAg阴性母亲的婴儿(1.54%)(χ2=18.140,P<0.05)。低出生体重儿的低/无应答率(14.58%)虽低于正常体重儿(17.01%),但差异无统计学意义(χ2=3.652,P>0.05)。结论月龄、疫苗种类、是否早产、母亲孕期HBsAg状态对婴儿的应答情况有影响。对早产儿及母亲HBsAg阳性儿等高危婴儿应进行Anti-HBs的滴度监测。更多还原

【Abstract】 Objective To understand the non-and-low response rate of neonates after immunization of hepatitis B vaccine produced by recombinant deoxyribonucleic acid techniques in yeast(HepB-Y)in Shanghai.Methods 2047 infants born during 2008-2009 in three districts of Shanghai were vaccinated with 3 dosages of HepB-Y according to schedule of 0-1-6 months were selected as subjects.Antibody to hepatitis B virus surface antigen[(HBsAg),anti-HBs]were detected by chemiluminescence microparticle immuno assay(CMIA),and related informations of birth and vaccines immunization were collected from parents by questionnaires.Results The geometric mean concentration(GMC)of anti-HBs was 408.04 mIU/ml after immunization of three dosages of HepB-Y.The rate of non-and-low response of infants was 17%,among them,the rate of non response was 1.86% and the rate of low response was 15.14%.The non-and-low response rate of 13-18 month old infants(23.03%)was higher than that of 7-12 months old infants(6.62%)(χ2=358.518,P<0.05).The non-and-low response rate of infants who was vaccinated by 5μg HepB-Saccharomyces Cerevisaie Yeast(21.68%)was higher than that of infants who was vaccinated by 10μg HepB-Hansenula Polymoarpha Yeast(3.10%)(χ2=415.024,P<0.05).The non-and-low response rate of premature infants(31.74%)was higher than that of full term infants(16.53%)(χ2=18.140,P<0.05).The non response rate of infants(7.62%)whose mother was positive of HBsAg when pregnancy was higher than that of infants(1.54%)whose mother was negative of HBsAg when pregnancy(χ2=18.140,P<0.05).The non-and-low response rate of low birth weight infants(14.58%)was lower than that of normal birth weight infants(17.01%).The difference,however,was not statistically significant(χ2=3.652,P>0.05).Conclusions Age,type of hepatitis B vaccines,premature,the status of HBsAg of mother during pregnancy could influence the response of infants to hepatitis B vaccine.The titer surveillance for high risk infants such as premature infants and infants who delivered by the mother with positive HBsAg should be strengthened.更多还原