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目的比较成人HepB初免低应答者使用4种HepB进行3剂次加强免疫后anti-HBs应答情况及影响因素。方法将低应答的18～49岁成人随机分4组,分别用10μg HepB-SC、10μg HepB-HP、20μg HepB-SC和20μgHepB-CHO,于0-1-6月进行3剂次加强免疫,对其进行问卷调查并于第3剂次后1月采集血标本,采用CMIA法检测anti-HBs。比较各组抗体应答情况,采用多因素回归分析其影响因素。结果免后总抗体阳转率为78.25%、10μg HepB-SC组、10μg HepB-HP组、20μg HepB-SC组和20μg HepB-CHO组分别为70.18%、78.79%、77.34%和84.62%,有统计学差异(P=0.004);总抗-HBs GMC为443.92 mIU/mL,4组分别为297.03、435.21、445.76和604.64 mIU/mL,亦有统计学差异(P<0.001)。多因素分析显示,初免抗体水平、疫苗种类、加强免疫疫苗种类与加强免疫后抗体阳转率和GMC有关。结论 HepB低应答成人3剂次加强免疫可获得较好抗体应答;20μg HepB-CHO效果好于10μg HepB-SC。
Objective To compare the anti-HBs response and the influencing factors of HepB naive low responders with 4 HepBs after 3 doses of booster immunization. Methods Low-responders aged 18-49 years old were randomly divided into 4 groups and were boosted with 3 doses of HepB-SC, 10μg HepB-HP, 20μg HepB-SC and 20μg HepB-CHO respectively. A questionnaire survey was conducted. Blood samples were taken after January 3 and the anti-HBs were detected by CMIA. The antibody response of each group was compared, and the influencing factors were analyzed by multivariate regression analysis. Results The positive rate of total antibody after immunization was 78.25%, 70.18%, 78.79%, 77.34% and 84.62% respectively in 10μg HepB-SC group, 10μg HepB-HP group, 20μg HepB-SC group and 20μg HepB- (P = 0.004). The total anti-HBs GMC was 443.92 mIU / mL, and the four groups were 297.03, 435.21, 445.76 and 604.64 mIU / mL, respectively. Multivariate analysis showed that the antibody level of primary immunization, the type of vaccine and the type of booster vaccine were related to the antibody positive rate and GMC after boosting immunization. Conclusion HepB low-response adults received three doses of intensive immunization to obtain better antibody response; 20μg HepB-CHO better than 10μg HepB-SC.