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目的掌握青海省乙型肝炎(乙肝)病毒表面抗原(HBsAg)阳性母亲所生婴儿乙肝疫苗(HepB)免疫后血清学检测(Post-vaccination serological test,PVST)现状,分析影响PVST开展的因素。方法在城市、农村、牧区选择6个县(区)12家医院,对2015年所有HBsAg阳性母亲的婴儿开展PVST回顾性调查,对医院产科医生和当地接种门诊医生开展PVST知晓情况调查。结果共调查HBsAg阳性母亲的婴儿276名,其中35名(12.68%)完成HepB免疫后开展了PVST;城市、农村、牧区PVST检测率分别为14.17%、12.31%、8.06%(χ~2=1.76,P>0.05)。Logistic回归分析显示,市级及以上医院出生、母亲为全职职业的婴儿PVST检测率高。在241名未开展PVST婴儿的母亲中,47.72%未收到医生告知,32.78%担心费用,11.62%觉得没必要,7.88%认为孩子太小不愿抽血。在154名产科、接种门诊医生中,56名(36.4%)、19名(12.34%)分别曾口头、书面告知HBsAg阳性母亲开展婴儿PVST。结论 HBsAg阳性母亲婴儿完成HepB免疫后PVST检测率低。产科、接种门诊医生的PVST知晓率低。需加强对家长的宣传和医务人员的培训,以提高婴儿PVST检测率。
Objective To investigate the status of post-vaccination serological test (Hepatitis B vaccine) in infants born to hepatitis B virus (HBsAg) -positive mothers in Qinghai province and analyze the factors affecting the development of PVST. Methods Twelve hospitals in 6 counties (districts) were selected in urban, rural and pastoral areas to conduct a retrospective PVST retrospective survey on all infants with HBsAg positive mothers in 2015 and to investigate the PVST awareness among hospital obstetricians and local inpatients. Results A total of 276 infants with HBsAg positive mothers were enrolled. Among them, 35 (12.68%) had PVST after completing HepB immunization. The PVST rates in urban, rural and pastoral areas were 14.17%, 12.31% and 8.06% (χ ~ 2 = 1.76 , P> 0.05). Logistic regression analysis showed that the detection rate of PVST in infants born at municipal level and above and mothers in full-time occupations was high. Out of 241 mothers who did not develop PVST, 47.72% did not receive a doctor’s notice, 32.78% worried about the cost, 11.62% felt that they were not needed, and 7.88% considered their children too reluctant to take blood. Among 154 obstetric and immunization clinicians, 56 (36.4%) and 19 (12.34%) had verbally and writtenly informed HBsAg-positive mothers of their infant PVST. Conclusion The detection rate of PVST after HepB immunization of HBsAg positive mothers is low. Obstetric, vaccination outpatient PVST awareness is low. The publicity of parents and the training of medical staff need to be strengthened in order to improve the detection rate of PVST in babies.