【摘要】 目的观察乙肝疫苗普种预防儿童期乙型肝炎病毒 (HBV)感染、降低乙肝发病率的免疫效果。方法建立肝病报告制度,对乙肝发病情况进行监测 ;以出生队列定群随访和横断面调查方法 ,观察新生儿接种乙肝疫苗后13年的免疫持久性、HBV感染标志变动和乙肝发病率 ;用放射免疫法测定HBV感染标志。结果乙肝疫苗纳入计划免疫轨道 ,母亲不筛检,新生儿接种常规剂量乙肝疫苗 ,乙肝疫苗平均接种率达到85%以上。免疫后13年的长期连续定群观察结果和免疫10年后的横断面调查结果显示,免疫人群的HBsAg阳性率已从既往的16.0%下降为2.3% ,HBV感染率从既往的51.5 %降至3.5% ,疫苗预防HBsAg的保护有效率达到89.7 % ,预防HBV感染的保护率达到96.2% ,1～13岁年龄组人群的急性乙型肝炎发病率已由18.38/10万降至1.6/10万,下降了91.3%,保护效果稳定。结论在肝癌高发区隆安县开展新生儿乙肝疫苗普种,可获得有效控制HBV感染和HBsAg慢性携带的长期免疫效果更多还原

【Abstract】 Objective To evaluate the long term effectiveness of preventive HBV infection and to monitor the incidence of hepatitis B in children to see possible impact on the program of Long An that was launched in 1986.Methods （1）Set up a surveillance system of hepatitis,to evaluate the possible impact on incidence of hepatitis B.（2） To serologically evaluate the effect of the program, a stratified random sampling of 1000 chidren in 1987 birth cohorts was recruited for long term follow up at the age 1₁3 years.（3） Cross_sectional seroepidemiolgical survey was carried out in the county in 1985 before the program and 10 years later. HBsAg, anti_HBs and anti_HBc were tested by RIA. Results The average coverage of hepatitis B vaccine was 89.1%.At 13 years after vaccination, the seropositivity for HBsAg in children has decreased from 16.0% to 2.3%,the annual effectiveness was 89.7%.HBV accumulated infection rate was 3.5%,protective rate was 96.2%.The incidence of acute hepatitis B was 1.60 per 100,000 in children aged 1-13 years, it decreased by 91.3% as compared with the incidence of 18.38 per 100,000 in same age group in 1985-1987.Conclusion Mass hepatitis B vaccination program in Long An County has proved to be effective in control of HBV chronic infection and incidence of acute hepatitis B in childhood.更多还原