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目的了解新生儿接种乙肝疫苗后的无(弱)应答情况,对其影响因素进行分析。方法选取2014年1月至2015年6月期间在河南省人民医院门诊接种乙肝疫苗的634例新生儿,均在接种第三剂次接种完成后的第42天采集静脉血2ml,分离血清,采用时间分辨免疫荧光法定量检测抗-HBs。设计统一调查表,固定经过培训的专门人员对新生儿监护人进行预防接种相关情况的调查。结果新生儿接种乙肝疫苗后无(弱)应答率为8.04%,影响新生乙肝疫苗免疫效果的因素有新生儿地区来源(OR=1.664,P=0.047)、母亲HBsAg(OR=1.054,P=0.001)、父亲HBsAg(OR=2.085,P=0.012)、母亲接种乙肝无(弱)应答史(OR=5.316,P<0.001)、父亲接种乙肝无(弱)应答史(OR=7.710,P<0.001)、按0、1、6免疫程序接种(OR=0.243,P=0.016)、母乳喂养(OR=0.194,P<0.001)。结论按规定时间接种疫苗、母乳喂养、控制HBsAg阳性的父亲或母亲血清HBV DNA含量对提高新生儿接种乙肝疫苗应答率,进而更有效的控制乙肝病毒感染,具有十分重要的现实意义。
Objective To understand the no (weak) response of neonates after hepatitis B vaccination and analyze the influencing factors. Methods A total of 634 newborns vaccinated with Hepatitis B vaccine in Henan Provincial People’s Hospital from January 2014 to June 2015 were enrolled. Blood samples were collected on the 42nd day after the third inoculation. Time-resolved immunofluorescence quantitative detection of anti-HBs. Design a unified questionnaire to screen trained neonatologists for vaccination of newborn guardians. Results There was no (weak) response rate of 8.04% to newborns vaccinated with hepatitis B vaccine. The neonatal hepatitis B vaccine immunization effect was related to neonatal origin (OR = 1.664, P = 0.047) (OR = 5.316, P <0.001), no history of HBsAg in infants (OR = 2.085, P = 0.012), no history of HBsAg (OR = ) Were vaccinated according to the 0,1,6 immunization schedule (OR = 0.243, P = 0.016), breastfeeding (OR = 0.194, P <0.001). Conclusions Vaccination, breastfeeding, and control of HBsAg positive father or mother serum HBV DNA content in order to improve the neonatal vaccination rate of hepatitis B vaccine, and thus more effective control of hepatitis B virus infection, has very important practical significance.