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本文探讨了影响乙型肝炎(HB)疫苗对HBsAg和HBeAg阳性母亲所生婴儿保护效果(PE)的因素。大或小剂量HB疫苗都能非常有效地预防高危新生儿的慢性HB感染,但有证据表明小剂量疫苗与HB免疫球蛋白(HBIG)同时使用比单独接种大剂量疫苗更能产生良好的保护作用(PE≥90%),但小剂量疫苗未必能提供高PE,完成全程免疫程序的新生儿中成为HBsAg慢性携带者(CC)的人数较多。另外,只要在出生时接种第1剂疫苗,两个月内接种第2剂疫苗,大剂量疫苗即使在出生时不与HBIG同时使用,也能提供高PE。
This article explores the factors that affect the protective effect of the hepatitis B vaccine on infants born to HBsAg and HBeAg-positive mothers (PE). Both large and small doses of HB vaccine are very effective in preventing chronic HB infection in high-risk neonates, but there is evidence that the combination of a low-dose vaccine with HB immunoglobulin (HBIG) produces better protection than a high-dose vaccine alone (PE ≥90%), but the low-dose vaccine does not necessarily provide high PE, and the number of newborns who have completed the full immunization schedule is more likely to become chronic carriers of HBsAg (CC). In addition, as long as the first dose of vaccine is given at birth and the second dose is administered within two months, the high dose of vaccine can provide high PE even if it is not used concurrently with HBIG at birth.