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目的调查军队人群乙肝血清抗体的本底水平,观察重组乙肝疫苗(20μg/ml)的免疫效果,为探索适合新兵、新学员的乙肝免疫程序打下基础。方法通过血清抗体初筛确定10 102名新兵为观察对象,免疫前抗-HBs检测结果为弱阳性者按照0、1程序接种2针乙肝疫苗,分别在2针后测抗-HBs水平;免疫前抗-HBs检测结果为阴性者按照0、1、6程序接种3针乙肝疫苗,分别在第2、3针后测抗-HBs水平;比较不同针次后的抗-HBs阳转率、抗体几何平均滴度(GMT)水平,阴性者的高应答反应。结果免疫前10 102名观察对象的血清抗-HBs检测中弱阳性者为1090人(10.8%),阴性者为3251人(32.2%)。弱阳性者接种乙肝疫苗1、2针后阳转率分别为90.0%、97.8%,GMT分别为5007.75 m IU/ml和6295.77 m IU/ml;接种2针阳转率明显优于接种1针(P<0.01)。阴性者接种乙肝疫苗2、3针后采血,阳转率分别为86.1%、98.7%,高应答反应率分别为56.4%、87.5%,GMT分别为1214.41 m IU/ml和2231.57 m IU/ml;接种3针阳转率明显优于接种2针(P<0.01)。本次试验期间,未收到三级(含)及以上不良反应报告。结论有必要在免疫前先进行抗-HBs检测,再选用重组乙肝疫苗(20μg/ml)进行科学接种;血清抗-HBs弱阳性对象选用0、1两针接种程序,血清抗-HBs阴性对象选用0、1、6三针接种程序,均可获得明显的免疫效果。
Objective To investigate the background level of serum hepatitis B antibody in military population and to observe the immune effect of recombinant hepatitis B vaccine (20μg / ml), so as to lay the foundation for exploring the hepatitis B immunization program suitable for recruits and new students. Methods A total of 10 102 recruits were enrolled in the study. Serum anti-HBs was weakly positive in pre-immunization patients. The 2-dose hepatitis B vaccine was given according to the 0 and 1 protocol, and the level of anti-HBs was measured after 2 doses. Anti-HBs test results were negative in accordance with the 0,1,6 program vaccination 3-pin hepatitis B vaccine, respectively, after the first and second needle anti-HBs levels; comparison of different needle after anti-HBs positive rate, antibody geometry Average titer (GMT) level, negative response to high response. Results 1092 (10.8%) were weakly positive for anti-HBs in 10 102 subjects before immunization and 3251 (32.2%) were negative. The positive rate of positive rate of Hepatitis B vaccination with 1 and 2 doses of Hepatitis B vaccine were 90.0% and 97.8%, respectively. The GMT was 5007.75 m IU / ml and 6295.77 m IU / ml, respectively. P <0.01). The positive rates of HBsAg and HBsAg were 86.1% and 98.7%, respectively. The high response rates were 56.4% and 87.5%, respectively. The GMTs were 1214.41 m IU / ml and 2231.57 mIU / ml respectively. Inoculation 3-pin positive rate was significantly better than 2-needle inoculation (P <0.01). During the trial, no reports of Grade 3 (including) and above adverse reactions were received. Conclusions It is necessary to conduct anti-HBs test before immunization and then use recombinant hepatitis B vaccine (20μg / ml) for scientific inoculation. The weak anti-HBs positive subjects choose 0 and 1 two-needle vaccination program, and the serum anti-HBs negative subjects are selected 0,1,6 three-needle inoculation procedures, can obtain significant immune effect.