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目的分析新生儿接种乙肝疫苗群体免疫的远期效果及影响因素。方法选择河北省正定县试点乡8个自然村1~19岁儿童少年为研究对象。采用固相放射免疫(RIA)法检测血清HBsAg、抗-HBs和抗-HBc;采用EpiInfo和SAS软件进行统计处理。结果免疫后1~19岁人群HBsAg阳性率由免疫前的9.48%下降为1.46%,抗-HBc阳性率也由免疫前的33.81%降至5.94%,抗-HBs阳性率62.13%,显著高于免疫前水平。乙肝疫苗3针全程免疫组儿童HBsAg阳性率最低,为0.35%。母亲HBsAg阳性儿童乙肝疫苗免疫失败而出现HBsAg的机率是母亲HB-sAg阴性儿童的33.5倍(OR)。结论新生儿乙型肝炎疫苗接种后群体免疫效果良好,母亲HBsAg携带状况和乙肝疫苗接种史是影响乙肝疫苗免疫效果的关键因素。
Objective To analyze the long-term effects and influencing factors of neonatal immunization with hepatitis B vaccine. Methods Children aged from 1 to 19 years in 8 villages in Pilot Township, Zhengding County, Hebei Province were selected as research objects. Serum HBsAg, anti-HBs and anti-HBc were detected by solid-phase radioimmunoassay (RIA). EpiInfo and SAS software were used for statistical analysis. Results The positive rate of HBsAg in 1- 19-year-olds decreased from 9.48% before immunization to 1.46%, the positive rate of anti-HBc decreased from 33.81% before immunization to 5.94%, and the positive rate of anti-HBs was 62.13% Pre-immune level. HBsAg positive rate of the 3-dose whole-dose immunization group of hepatitis B vaccine was the lowest, 0.35%. Mice HBsAg-positive children with hepatitis B vaccine immunosuppression HBsAg chance of occurrence is 33.5 times (OR) of mothers HB-sAg-negative children. Conclusions The immunity of the population is good after the newborn hepatitis B vaccination. The mother’s HBsAg carrier status and the history of hepatitis B vaccination are the key factors influencing the immune effect of hepatitis B vaccine.