论文部分内容阅读
目的观察低/无应答成人接种不同剂量乙肝疫苗后乙肝病毒表面抗体(抗-HBs)阳转情况,评价两种大剂量乙肝疫苗的免疫效果。方法选择乙肝病毒表面抗原(HBs Ag)、乙肝病毒e抗原(HBe Ag)阴性,抗-HBs几何平均滴度(GMT)<100 m IU/m L的低应答成人49人、无应答成人274人为调查对象,根据知情同意、随机原则分为两组:一组为20μg组,即按0、1、6个月免疫程序接种乙肝疫苗;一组为60μg组,即接种一针60μg乙肝疫苗。免疫后3个月内复查乙肝五项指标。结果再免疫后,两组人群抗-HBs GMT分布差异无统计学意义(无应答成人χ~2=5.946,P=0.051;低应答成人χ~2=0.437,P=0.509);抗-HBs阳转成人中,GMT在10~100 m IU/m L范围的无应答成人,20μg组低于60μg组,差异有统计学意义(Z=-3.595,P=0.000);女性抗-HBs应答水平高于男性(χ~2=8.380,P=0.015);各年龄段应答水平差异无统计学意义(χ~2=8.559,P=0.200)。结论低/无应答成人接种一针60μg乙肝疫苗与全程接种三针20μg乙肝疫苗疗效相当。
Objective To observe the positive conversion of hepatitis B virus surface antibody (anti-HBs) in adults with low / no response to different doses of hepatitis B vaccine and evaluate the immune effects of two high-dose hepatitis B vaccines. Methods HBs Ag, HBeAg negative, 49 individuals with low response to anti-HBs geometric mean titers (GMT) <100 m IU / m L and 274 adults without response According to the principle of informed consent and randomness, the subjects were divided into two groups: one group was 20μg group, that is, hepatitis B vaccine was vaccinated according to 0, 1 and 6 months of immunization program; the other group was 60μg group, which was vaccinated with a single dose of 60μg hepatitis B vaccine. Three months after immunization review of hepatitis B five indicators. Results After re-immunization, there was no significant difference in anti-HBs GMT distribution between the two groups (χ ~ 2 = 5.946, χ ~ 2 = 0.437, P = 0.509 for unresponsive adults; In adults, there was no response to GMT in the range of 10 ~ 100 m IU / m L, and the difference was statistically significant (Z = -3.595, P = 0.000) in 20 μg group and less than 60 μg group In males (χ ~ 2 = 8.380, P = 0.015), there was no significant difference in response level among all age groups (χ ~ 2 = 8.559, P = 0.200). Conclusion Low / non-responder adults receiving one dose of 60 μg hepatitis B vaccine have the same efficacy as the full-dose three-dose 20 μg hepatitis B vaccine.