【作者】 孙忠清； 马爱勤； 汪照国； 沈遥； 钟春梅； 汪之顼；

【Author】 SUN Zhong-qing*,MA Ai-qin,WANG Zhao-guo,SHEN Yao, ZHONG Chun-mei,WANG Zhi-xu.* Qingdao University Medical School,38 Dengzhou Road,Qingdao 266021,China

【机构】 青岛大学医学院； 山东省临沂市人民医院营养科； 山东省青岛市疾病预防与控制中心； 湖南师范大学化学生物学与中药分析教育部重点实验室； 南京医科大学公共卫生学院；

【摘要】 目的观察补充鱼肝油对婴幼儿乙肝疫苗再免疫效果的影响。方法于2008年10月-2009年3月间,招募山东临沂某农村地区所有按国家计划免疫常规全程接种过乙肝疫苗的7～36月龄婴幼儿,检测其血清抗乙肝疫苗抗体(抗-HBs)浓度,对其中100名血清抗-HBs水平较低的婴幼儿进行随机、双盲、安慰剂对照的VA干预实验。采用市售浓缩鱼肝油作为VA补充剂,补充期3个月,每15d补充一次,每次0.5每次2.5万IU,共补充6次;对照组给予等体积玉米油。在干预实验开始后的30d和60d后,给婴幼儿进行乙肝疫苗再免疫接种,第90天采集婴幼儿血清样本。用高效液相色谱法(HPLC)测定干预实验前后婴幼儿血清VA浓度。用电化学发光免疫分析法(ECLIA)测定血清抗-HBs水平。结果完成全程干预实验的婴幼儿共74名,实验组和对照组各37名,其中失访16例(实验组9例,对照组7例),剔除自行额外服用含VA营养补充剂者7例(实验组2例,对照组5例),采血失败3例(实验组2例,对照组1例)。干预后,实验组儿童的血清VA浓度、血清抗-HBs水平皆高于对照组。实验组乙肝疫苗弱、无应答率低于对照组。结论补充鱼肝油可显著提高儿童乙肝疫苗再免疫后血清抗-HBs水平,原因可能来自VA营养状况的改善。更多还原

【Abstract】 Objective The object of this study was to observe the interventional effect of vitamin A supplementation on re - vaccination to Hepatitis B virus(HBV) among rural infants and young children in China.Methods All 7～36 months old children,who had been vaccinated with obligatory HBV vaccines routinely by the National Technical and Administrative Procedures for HBV Vaccination on Children of China,were convened among 10 villages in Linyi, Shandong Province,in October 2008.After detection of serum anti - HBV,one hundred children,with lower serum anti - HBV,were picked out for the randomized,double blind,placebo controlled vitamin A supplementation study. The children in the intervened group took the VA supplementations every 15 days(the supplementation period was 3 months,with total 6 times and 25000IU VA of dose per time).The children in the control group were given corn - oil with same volume as that of VA dose.All children were re - vaccinated with 5μg recombinant yeast - derived HBV vaccine by intramuscular injection in triangular muscles at the 30th and the 60th day of the experiment.The serum samples were collected from each child at the 90th day of the experiment.Retinol concentrations in serum samples were analyzed with HPLC method.The levels of serum anti - HBs were detected by the electro - chemi - luminescence immunoassay (ECLIA).Results Total 74 children finished the supplemental experiment and blood collection,37 in each group,respectively,with 26 children dropping out for the reasons of feeding compliance and blood collecting.Before the intervention,the children in two groups had similar serum VA level and similar VA deficiency prevalence.After intervention of VA supplementation with 6 doses of 25000IU in 75 days,the children in the intervened group had significantly increased serum VA level compared with baseline and the level of the control group.The VA supplemented children presented higher serum anti - HBs level than the controls in the time of 30 days after the last HB re - vaccination. Conclusion The results show that VA supplementation may enhance the re - vaccination reaction against HB vaccine in infants and young children.The VA status of children may be proved as one of influencing factors for efficiency of Hepatitis B vaccination.更多还原