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目的研究乙肝疫苗(Hepatitis B Vaccine,HepB)基础免疫后12～15年乙肝病毒表面抗原抗体(抗-HBs)衰减者加强免疫前后抗体水平间的关系,比较不同剂次的加强免疫效果。方法选择婴儿期完成HepB基础免疫的1993—1997年出生的儿童,采集静脉血,使用化学发光法检测后,HBsAg及抗-HBc阴性而抗-HBs降至保护性水平(10mIU/ml)以下作为研究对象。按抗-HBs滴度水平分为3组:Ⅰ组(﹤0.1 mIU/ml)、Ⅱ组(0.1～1 mIU/ml)和Ⅲ组(﹥1 mIU/ml);按0、1、6免疫程序加强免疫3剂10μg的重组乙肝疫苗(汉逊酵母)(HepB-HPY),分别于免疫1剂和3剂后1个月采集静脉血,检测抗-HBs。结果 453名研究对象加强免疫1剂后各组抗-HBs阳转率分别为67.96%、85.61%和97.60%,抗体滴度分布差异有统计学意义(χ2=132.88,P﹤0.05),几何平均浓度(GMC)分别为37.31、152.77和1310.27 mIU/ml(F=86.11,P﹤0.05);加强免疫3剂后各组抗-HBs阳转率分别为99.00%、99.21%和99.49%(Fisher确切概率法,P﹤0.05),GMC分别为1714.67、1502.32和3383.68 mIU/ml(F=16.59,P﹤0.05)。全程采血的425名儿童在免疫1剂和3剂后抗体阳转率分别为87.76%和99.29%(χ2=46.68,P﹤0.05)。结论对于完成HepB基础免疫后抗体衰减至10 mIU/ml以下的12～15岁儿童有必要进行加强免疫,加强免疫前抗体滴度较高者加强免疫效果较好;加强免疫3剂比1剂效果好。
Objective To study the relationship between antibody levels before and after immunization with hepatitis B virus surface antigen antibody (anti-HBs) attenuated 12 to 15 years after the basic immunization of Hepatitis B Vaccine (HepB), and to compare the effect of different doses of boosting immunity. Methods Children born from 1993 to 1997 who completed basic HepB immunization in infancy were enrolled in this study. Blood samples were collected for detection of HBsAg and anti-HBc negative and anti-HBs to a protective level (10mIU / ml) following chemiluminescence detection as Research object The anti-HBs titer was divided into three groups: group Ⅰ (<0.1 mIU / ml), group Ⅱ (0.1-1 mlU / ml) and group Ⅲ (> 1 mlU / ml) Three doses of 10 μg recombinant Hepatitis B vaccine (HepB-HPY) were immunized with the program, and venous blood was collected one month after the first and third doses of immunization to detect anti-HBs. Results The positive rate of anti-HBs positive in each group was 67.96%, 85.61% and 97.60%, respectively. The antibody titers in the 453 subjects were significantly increased (χ2 = 132.88, P <0.05) (F = 86.11, P <0.05). After three doses of booster immunization, the anti-HBs positive rates in each group were 99.00%, 99.21% and 99.49%, respectively Probability method, P <0.05), GMC were 1714.67,1502.32 and 3383.68 mIU / ml respectively (F = 16.59, P <0.05). The positive rate of antibody positive rate of 425 children who took blood at one dose and three doses after immunization were 87.76% and 99.29% respectively (χ2 = 46.68, P <0.05). Conclusion It is necessary to strengthen the immunization of 12-15-year-old children whose antibody is attenuated to 10 mIU / ml after HepB basic immunization, and to strengthen the antibody titer higher before immunization to enhance the immune effect; to strengthen the effect of 3 doses to 1 dose it is good.