北京市海淀区新生儿乙型肝炎疫苗高免疫应答影响因素调查

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目的探讨北京市海淀区新生儿12月龄内全程接种10μg酵母乙型肝炎疫苗(hepatitis B vaccine,Hep B)的免疫效果及影响乙肝表面抗体(抗-HBs)高应答的因素。方法对在北京居住半年及半年以上、12月龄内完成全程Hep B接种的儿童家长进行调查,获得儿童一般情况、Hep B接种情况、体重、身长、出生体重、是否早产、母亲分娩方式、喂养方式、母亲乙肝表面抗原(hepatitis B surface antigen,HBs Ag)和乙肝e抗原(hepatitis B e antigen,HBe Ag)、父亲HBs Ag情况等数据,采集被调查儿童静脉血标本2 ml,分离血清,定量检测抗-HBs和HBs Ag。以非条件多因素Logistic回归模型分析抗-HBs高应答率(抗-HBs≥1 000 IU/L)的影响因素,估计各研究因素的比值比(odds ratio,OR)和95%可信区间(confidence intervals,CI)。结果共调查7~15月龄儿童691名,纳入分析666名,儿童无HBs Ag阳性出现,抗-HBs阳性(≥10 IU/L)率达99.8%(665/666);抗-HBs阳性的儿童中,低应答(抗-HBs≥10 IU/L且<100 IU/L)率1.2%,中应答(抗-HBs≥100 IU/L且<1 000 IU/L)率34.0%,高应答率64.8%。经Logistic回归模型分析,与女童相比,男童全程接种Hep B后更易产生抗-HBs高应答(OR=1.396,95%CI:1.010~1.930);与采血时间距第3剂Hep B(Hep B3)间隔<60 d的儿童相比,间隔≥60 d的儿童抗-HBs高应答率更低(OR=0.326,95%CI:0.186~0.573)。结论北京市海淀区新生儿12月龄内全程接种Hep B后,产生的抗-HBs阳性率高。抗-HBs阳性的儿童中,抗-HBs高应答率随着采血时间和Hep B3间隔的延长而下降,男童抗-HBs高应答率高于女童。 Objective To investigate the immune effect of Hep B vaccinated with 10 μg of Hep B inoculated in 12-month-old newborns in Haidian District, Beijing and the factors influencing the high-level response of hepatitis B surface antibody (anti-HBs). Methods A survey of parents of children who had completed Hep B inoculation within 12 months of their stay in Beijing for half a year or more and more than half a year and 12 months of age was conducted. Their general conditions, Hep B inoculation, weight, length, birth weight, premature delivery, mother’s delivery mode, , Mother’s hepatitis B surface antigen (HBsAg) and hepatitis B e antigen (HBeAg), the father of HBsAg and other data collected from the children were investigated venous blood samples 2 ml, serum was separated, quantitative Anti-HBs and HBs Ag were detected. The factors influencing the high-response rate of anti-HBs (anti-HBs≥1 000 IU / L) were analyzed by unconditional multivariate logistic regression model. The odds ratio (OR) and 95% confidence interval confidence intervals, CI). Results A total of 691 children aged 7 to 15 months were enrolled in this study. 666 children were included in the analysis. No HBs Ag positive children were found, and the positive rate of anti-HBs (≥10 IU / L) was 99.8% (665/666). The anti-HBs positive In children, low response (anti-HBs ≧ 10 IU / L and <100 IU / L) was 1.2% and moderate response (anti-HBs ≧ 100 IU / L and <1000 IU / L) was 34.0% Rate 64.8%. Logistic regression analysis showed that boys were more likely to develop anti-HBs hyperactivity (OR = 1.396, 95% CI: 1.010-1.930) than Hep B after vaccination with Hep B (Hep B3) Children with an interval of 60 days had lower anti-HBs response rates (OR = 0.326, 95% CI: 0.186-0.573) than children at 60 days. Conclusion The positive rate of anti-HBs produced by Hep B inoculation within 12 months of newborns in Haidian District, Beijing was high. Anti-HBs-positive children, anti-HBs high response rate with the blood collection time and Hep B3 interval decreased, the high rate of anti-HBs in boys is higher than that of girls.
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