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目的评价贵州省乙型肝炎疫苗(Hep B)免疫策略的母婴阻断效果。方法用分层随机抽样法,抽取4个市州的9个县级医院作为调查单位,对其院分娩的孕妇及所生新生儿Hep B免疫后血清采用酶联免疫吸附试验检测HBV标志物(HBVM),分析其血清HBs Ag、抗乙肝病毒表面抗原抗体(Anti-HBs)和抗乙肝病毒核心抗原抗体(Anti-HBc)水平以及疫苗保护水平。结果 421名新生儿均按0、1、6程序接种Hep B,孕妇HBs Ag阳性的新生儿HBs Ag阳性率为19.48%,Hep B保护率为77.08%。孕妇HBs Ag、HBe Ag双阳性的新生儿HBs Ag阳性率28.38%,Hep B保护率为66.62%;HBs Ag阳性孕妇所生新生儿,其Anti-HBs阳性率明显高于HBs Ag、HBe Ag阳性孕妇所生新生儿(χ~2=6.040,P<0.05)。421名新生儿anti-HBs阳性率为78.10%。孕妇感染HBV模式有19种,HBs Ag、HBe Ag和Anti-HBc阳性(大三阳)、HBs Ag、Anti-HBe、Anti-HBc(小三阳)占总感染孕妇数的70.07%,其所生新生儿接种Hep B后有9.17%为大、小三阳感染。结论贵州省孕妇HBs Ag阳性所生新生儿Hep B保护率有待进一步提高,孕妇HBs Ag和HBe Ag双阳性以及大、小三阳感染所生新生儿是HBV母婴阻断重点防控人群,建议加大Hep B接种剂量并联合HBIG免疫,避免HBV感染。
Objective To evaluate the effect of hepatitis B vaccine (Hep B) immunization strategy in Guizhou province. Methods Stratified stratified random sampling method was used to select 9 county-level hospitals in 4 prefectures and cities as the investigation unit. Serum samples of pregnant women and newborn infants Hep B after immunization were detected by enzyme-linked immunosorbent assay (ELISA) HBVMs were used to analyze the levels of anti-HBs, anti-HBs and anti-HBc in serum and vaccine protection. Results 421 newborns were vaccinated with Hep B according to 0, 1 and 6 procedures. The positive rate of HBs Ag in HBs Ag positive pregnant women was 19.48% and that of Hep B was 77.08%. The positive rate of HBsAg in HBsAg and HBeAg-positive neonates was 28.38% and that of Hep B was 66.62% in pregnant women. The positive rate of anti-HBs in HBsAg-positive pregnant women was significantly higher than that in HBsAg and HBeAg Neonates born to pregnant women (χ ~ 2 = 6.040, P <0.05). 421 newborn anti-HBs positive rate was 78.10%. 19 pregnant women infected with HBV mode, HBsAg, HBeAg and Anti-HBc positive (big three positive), HBsAg, Anti-HBe, Anti-HBc 9.17% of newborns vaccinated with Hep B were large and small Sanyang infections. Conclusion The protection rate of HBsAg-positive neonates born in Guizhou province needs to be further improved. HBsAg and HBeAg-positive pregnant women as well as newborns born by big and small Sanyang infection are the key prevention and control population of HBV infection, Large Hep B vaccination dose combined with HBIG immunization, to avoid HBV infection.