【摘要】 目的 :探讨血源性乙型肝炎疫苗 ,对HBsAg(乙型肝炎表面抗原 )阳性母亲所生新生儿的免疫持久性。方法 :应用RPHA法从 15 0 0名孕妇中筛查出 82名HBsAg≥ 1∶64的滴度阳性携带者的新生儿 ,按随机、双盲、设安慰剂的原则将研究对象分为疫苗组和对照组 (人数比例为 3 :1)。疫苗组在新生儿出生 2 4小时内注射第 1针 ,1月、6月龄分别注射第 2针、3针乙肝疫苗 ,对照组按同样程序注射安慰剂。结果 :在第 13年时疫苗组抗 -HBs阳性率仍高达 5 9.3 2 % (3 5 /5 9) ;对照组 13年中有 2 3 .5 3 % (4 /17)受到自然感染后变为HBsAb(乙型肝炎表面抗体 )阳性 ,疫苗组与对照组有显著性差异 (P <0 .0 5 )。疫苗组的HBsAb阳性者中 ,HBsAbGMT峰值也在第 12个月 ,S/N值为68.84,到 13年时已下降到 17.82 ,相当于高峰的 1/4 ,但仍明显高于对照组。除了出生时疫苗组与对照组HBsAg阳性率无明显差异外 ,疫苗组HBsAg阳性率一直明显低于对照组 ,在第 13年时疫苗组和对照组的HBsAg阳性率分别为 6.77%、47.0 6% ,有显著性差异 (P <0 .0 5 )。结论 :HBsAg阳性母亲的新生儿进行乙型肝炎疫苗免疫 13年时 ,大部分仍有较好的保护效果 ,发生HBsAg阳转者多发生于当初免疫失败和HBsAb滴度较低者中 ,对这一部分高危人群在适当时间应筛查HBsAb ,对更多还原

【Abstract】 Objective: To determine the immune persistence in neonates born to hepatitis Bsurface antigen (HBsAg) positive mothers with local produced plasma derived HB immunization.Methods: 82 infants who were born by HBV carrier mothers were divided into two groups accrding to randomized,placebo controlled method,one was vaccine group and another was controlled group (proportion of number was 3:1).The three doses of hepatitis B vaccine were injected on infants which were in vaccine group within 24 hours after born, first month and 6th month.It was the same in controlled group but vaccine was replaced by placbo. Results: The rate of anti HBs positive in vaccine group reaches the peak (67.8% 40/59) on 12th month,then it come to decline slowly to 59.32% (35/59) on the 13th year. There are 23.53%( 4/17) subjects become anti HBs positive in controlled group by natural infection. The difference between the groups are significant during the studying time. On the contrary with anti HBs,the rates of HBsAg are lower in vaccine group than controlled group during the time.They were 6.77% in vaccine group and 47.06% in controlled group respectively on the 13th year ( P <0.05). Conclusion: The paofect effect of hepatitis bvaccine is good even after 13 years of immunization.It is necessery to boost immunization to those whose anti HBs titer is low.更多还原