【摘要】 乙型肝炎 (乙肝 )疫苗免疫后 ,体液和细胞免疫回忆应答的状况和特点 ,是确定是否需要加强免疫及免疫方案的关键。为此 ,在湖南省湘潭市随机采样 ,抽取 170名 1986～ 1988年出生、完成了血源乙肝疫苗全程免疫后 9～ 11年的儿童 ,用重组 (酵母 )乙肝疫苗进行 1～ 3次加强免疫 ,观察其体液免疫应答。在浙江省杭州市 ,随机抽取 2 8名血源乙肝疫苗母婴阻断免疫者、18名全程免疫儿童和 11名未免疫的健康人 ,观察他们的外周血淋巴细胞 (PBMC)对基因重组乙肝表面抗原 (HBsAg)刺激的增殖反应。结果显示 :乙肝疫苗全程免疫后 9～ 11年的儿童 ,完成 1针、2针和 3针法加强免疫后 1年内 ,乙肝病毒表面抗体 (抗 -HBs)阳性率和几何平均滴度 (GMT)均迅速升高 ,三组的GMT分别比加强免疫前提高了 6 5、9 3、2 4 2倍 ,阳性率均上升至 10 0 % ,加强免疫次数多抗体提高多 ,各组间GMT差异有非常显著的统计学意义 (P <0 0 1)。完成加强免疫后 ,3次加强免疫组抗 -HBs阳性率比 <3次组下降缓慢 ,至加强免疫后第 3年 ,抗 -HBs阳性率 1针法降为 71 2 % ,2针法降为 79 2 % ,而 3针法维持在 92 5 %。血源乙肝疫苗全程免疫者其PBMC对重组HBsAg刺激的特异性增殖反应强度和γ干扰素 (INF -γ)水平明显高于对照组 ,细胞免疫反应的强度?更多还原

【Abstract】 Status and characterization of long term humoral and cellular immune memory are the keys to answer whether or not the booster vaccination after basic hepatitis B immunization is necessary. A total of 170 children who were born in 1986～1988 in Xiangtan of Hunan Province and had received a whole course plasma derived hepatitis B vaccine 9～11 years ago were randomly boosted 1～3 times(naming boosting groups 1,2,3)using yeast derived HB vaccine to observe their humoral immunological response And besides, peripheral blood mononuclear cell(PBMC)mediated immunological response towards recombinant hepatitis B surface antigen(rHBsAg)stimulation was evaluated among 46 HBV vaccinated adolescents in Hangzhou of Zhejiang Province. The results showed that within one year of boosting,the geometric mean titers(GMT)of anti HBs increased rapidly by 6 5,9 3,and 24 2 times as compared with the baselines before boosting among boosting groups 1,2 and 3,respectively Positive rates of anti HBs rose to 100% among all of the boosting groups The level of antibody to HBsAg was higher in boosting group 3 than the other two groups Antibody against HBsAg decreased more slowly in boosting group 3, positive rates of anti HBs decreased from 100% to 71 2%,79 2%,92 5% 3 years after boosting among three boosting groups respectively rHBsAg induced stimulation index(Sl)and IFN r level of PBMC were higher among adolescents inoculated with plasma-derived hepatitis B vaccine than that of the controls A positive correlation was observed between SI of PBMC and anti HBs background of immunized adolescents. These results suggest that immunological memory after hepatitis B vaccination can persist for more than 11 years.Memory responses are related to the immunological background,responsive intensity is positively related to times of vaccine boosting. lmmunological memory response may play an important role in long term efficacy of hepatitis B vaccine更多还原