【摘要】 目的观察乙肝表面抗原(HBsAg)阳性孕妇所生新生儿采取重组酵母乙型肝炎疫苗(10μg,0-1-6三针)联合乙肝免疫球蛋白(HBIG,100IU或200IU)免疫后3年内的抗体持久性,为制定科学强化免疫策略提供依据。方法新生儿7月龄时及1岁、2岁和3岁时分别采血,追踪观察按照免疫程序免疫后3年内儿童的抗-HBs动态变化情况及持久性。结果儿童的抗-HBs无应答、低应答、正常应答和高应答率分别由7个月时的0.76%、5.34%、38.17%、53.18%(有2.54%感染HBV),变为3岁时的25.13%、44.67%、18.73%和7.68%(有3.79%感染HBV),差异有统计学意义(P<0.001)。3岁时低应答和累计无应答率达到69.80%。抗-HBs几何平均滴度由7个月时的997.56mIU/ml降为3岁时的59.06mIU/ml。7个月时为低应答、正常应答和高应答的,各有一例在3岁前感染。结论母亲HBsAg阳性的,需定期检测抗-HBs,免疫后1-2年加强免疫。更多还原

【Abstract】 Objective To provide a scientific basis for making booster immunization strategy and explore the antibody persistence of immunization with hepatitis B vaccine(YDV,10μg,at the age of 0,1,and 6 months) combined with different doses of hepatitis B immunoglobulin(100IU or 200IU) in 3 years among infants born by hepatitis B surface antigen positive mothers. Methods To observe the dynamic change and persistence of antibody among infants,titers of the antibody against hepatitis B surface antigen(anti-HBs) were detected respectively among children at the age of 7 months,1,2 and 3 years after the primary vaccination. Results Children’s no,low,normal and high antibody response rates were 0. 76%,5. 34%,38. 17%,53. 18%(2. 54% infected with HBV) by 7 months,which changed to 25. 13%,44. 67%,18. 73% and 7. 68%(3. 79%infected with HBV) respectively by 3 years old,the difference was statistically significant(P < 0. 001). The rate of low and cumulative no antibody response rate was 69. 80% at the age of 3 years. The GMC of anti-HBs dropped to 59. 06 mIU/ml by three years old from 997. 56 mIU/ml at the age of seven months(P < 0. 001) in the following-up periods. There were three new HBV infections by three years old among the children(3/429),with low,normal or high antibody response to hepatitis B primary vaccination respectively at the age of 7 months. Conclusion The study results suggest that serological markers of HBV should be tested on a regular basis among children born by hepatitis B surface antigen positive mothers,and after 1 or 2 years,immunity should be strengthened with supplementary HBV vaccination.更多还原