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目的分析不同剂量重组乙型病毒性肝炎(乙肝)疫苗(Hep B)对孕妇乙肝病毒表面抗原(HBs Ag)阳性所生新生儿的阻断效果,为调整Hep B免疫策略提供依据。方法采用分层随机抽样方法,抽取贵州省4个市州的9个县级医院作为调查单位,对调查单位HBs Ag筛查阳性的335名孕妇所生新生儿分别接种5μg和10μg重组酵母Hep B(5μg组和10μg组),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)、Anti-HBc水平以及疫苗保护水平。结果 5μg组193名,10μg组142名。5μg组HBs Ag阳性率为27.46%,Anti-HBs阳性率为69.95%,Anti-HBc阳性率为34.20%,HBs Ag+HBe Ag阳性率为13.99%,Hep B保护率为67.69%;10μg组HBs Ag阳性率为16.90%,Anti-HBs阳性率为80.28%,Anti-HBc阳性率为23.94%,HBs Ag+HBe Ag阳性率为6.34%,Hep B保护率为80.12%。5μg组的HBs Ag阳性率、Hbs Ag+HBe Ag阳性率高于10μg组(χ~2=4.575、4.228,P均<0.05);10μg组的Anti-HBs阳性率明显高于5μg组,两组比较,差异有统计学意义(χ~2=4.053,P<0.05)。结论接种10μg重组酵母Hep B免疫及阻断效果优于接种5μg重组酵母Hep B。建议对无应答者加大剂量或更换Hep B种类再次进行全程免疫,进一步提高Anti-HBs阳性率,避免HBV感染的发生。
Objective To analyze the blocking effects of different doses of recombinant Hepatitis B virus (HepB) on neonates born to hepatitis B virus surface antigen (HBs Ag) positive in pregnant women and provide basis for adjusting Hep B immunization strategy. Methods Taken stratified random sampling method, 9 county-level hospitals in 4 cities and prefectures in Guizhou Province were selected as the investigation units. Five hundred and ten micrograms of recombinant yeast Hep B (5μg group and 10μg group). Serum samples were tested for HBV markers (HBVMs) by enzyme-linked immunosorbent assay (ELISA), and their serum HBsAg, Anti-HBs and Anti- HBc), Anti-HBc levels and vaccine protection levels. The results of 5μg group 193, 10μg 142 group. The positive rate of HBsAg in 5μg group was 27.46%, the positive rate of Anti-HBs was 69.95%, the positive rate of Anti-HBc was 34.20%, the positive rate of HBs Ag + HBe Ag was 13.99% and the protection rate of Hep B was 67.69% The positive rate of Ag and HBeAg was 16.90%, 80.28%, 23.94% and 6.34%, respectively. The protection rate of Hep B was 80.12%. The positive rates of HBsAg and HbsAg + HBeAg in 5μg group were higher than those in 10μg group (χ ~ 2 = 4.575,4.228, P <0.05). The positive rate of Anti-HBs in 10μg group was significantly higher than that in 5μg group The difference was statistically significant (χ ~ 2 = 4.053, P <0.05). Conclusion Immunization and blocking effect of Hep B vaccinated with 10μg of recombinant yeast is better than inoculation of 5μg recombinant HepB. Proposed to increase the dose of non-responders or replacement of Hep B species again full immunization, and further improve the anti-HBs positive rate, to avoid the occurrence of HBV infection.