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目的了解新生儿接种乙肝疫苗后无(低)应答率,评价无(低)应答儿童再接种乙肝疫苗后免疫效果。方法在深圳市南山区、东莞市预防接种门诊按0、1、6月龄免疫程序接种5μg重组酵母乙肝疫苗后1～6个月的婴儿中,随机选择1913名作为研究对象,问卷调查儿童性别、出生体重、是否早产、母亲乙肝感染状况、乙肝疫苗接种史等,并采集其血清,用放射免疫法检测乙肝病毒表面抗原(HBsAg)、乙肝病毒表面抗体(抗-HBs)、乙肝病毒核心抗体(抗-HBc)。选择以上研究对象中无(低)应答的109名儿童分别用10μg汉逊酵母乙肝疫苗和10μg CHO重组乙肝疫苗按0、1、6月程序再免疫,接种3针后1个月再检测抗-HBs。结果1913名新生儿接种乙肝疫苗后无(低)应答率为31.42%,其中无应答率为3.24%,低应答率为28.18%。母亲HBsAg阳性或HBeAg阳性的新生儿无应答率为7.47%、18.37%,分别高于母亲阴性的新生儿(3.04%、3.05%)(均P<0.01),低体重儿的无应答率(8.06%)高于非低体重儿(3.12%)(P<0.05),母亲HBeAg阳性的新生儿抗-HBs滴度明显低于母亲阴性的新生儿(P<0.05)。无(低)应答的儿童接种10μg CHO重组乙肝疫苗、10μg汉逊酵母乙肝疫苗后再免成功率分别为83.08%(54/65)、88.64%(39/44)(P>0.05),抗-HBs平均滴度分别为225.56、209.23m IU/mL(P>0.05)。结论新生儿出生体重偏低、母亲乙肝感染状况可能影响新生儿接种乙肝疫苗的应答率,对无(低)应答的儿童进行再免疫3针乙肝疫苗效果良好。
Objective To understand the no (low) response rate of neonates vaccinated with Hepatitis B vaccine and to evaluate the immune effect of children with no (low) response to Hepatitis B vaccine re-vaccination. Methods Nineteen13 infants randomly selected from 1 to 6 months after inoculation of 5μg of recombinant yeast hepatitis B vaccine at 0, 1, 6 months old immunization program in Nanshan District, Dongguan City, Guangdong Province vaccination clinic were randomly selected as the study subjects, , Birth weight, whether or not premature delivery, mother’s hepatitis B infection, history of hepatitis B vaccination, etc. were collected and their serums were collected. HBsAg, hepatitis B virus surface antigens (anti-HBs), hepatitis B virus core antibody (Anti-HBc). A total of 109 children without (low) response to the above study were re-immunized with 10 μg of Hansenula Hepatitis B vaccine and 10 μg of CHO recombinant hepatitis B vaccine respectively according to the 0, 1, and 6 months of treatment. After 3 months of inoculation, HBs. Results 1913 newborns vaccinated with hepatitis B vaccine (low) response rate was 31.42%, of which non-response rate was 3.24%, low response rate was 28.18%. The nonresponse rates of neonates with HBsAg positive or HBeAg positive mothers were 7.47% and 18.37%, respectively, higher than that of mothers negative (3.04%, 3.05%) (all P <0.01) %) Was higher than that of non-low-birth-weight children (3.12%) (P <0.05). The titers of HBeAg-positive neonates with anti-HBs were significantly lower than those of negative neonates (P <0.05). Children with no (low) response received 10μg CHO recombinant hepatitis B vaccine and 10μg Hansenula hepatitis B vaccine, with the success rates of 83.08% (54/65), 88.64% (39/44) (P> 0.05) The average titers of HBs were 225.56 and 209.23 m IU / mL, respectively (P> 0.05). Conclusion Neonatal birth weight is low, mother’s hepatitis B infection status may affect the response rate of neonates vaccinated with hepatitis B vaccine, and immunization of children with no (low) response 3-dose hepatitis B vaccine is effective.