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目的了解抗-HBc阳性小学生和对照人群接种CHO乙型肝炎疫苗效果,分析自然感染人群对乙型肝炎疫苗免疫应答强度,为制定乙肝防治策略提供依据。方法采用个体匹配病例对照研究方法,抽取乙型肝炎病毒自然感染者(抗-HBc阳性)125人,按1︰1比例选取同一班级,性别、年龄相同未感染过乙肝病毒,同时未接种过乙肝疫苗125人作为对照组,进行血清学观察。结果抗体总阳转率为85.6%,其中实验组80.8%,对照组90.4%。实验组几何平均浓度(GMC)为7087.02IU/ml,对照组6517.88IU/ml;免疫后1个月两组之间抗体阳转率差异有统计学意义(χ2=4.67,0.01﹤P﹤0.05)。分年龄组抗体阳转率差异无统计学意义,7～8岁(χ2=3.38,P﹥0.05)、9～10岁(χ2=1.55,P﹥0.05)、11～12岁(χ2=0.00(校正),P﹥0.05)。结论未接种过乙肝疫苗和未感染过乙肝病毒人群接种效果较好。几何平均浓度实验组高于对照组可能与免疫记忆有关。实验组和对照组儿童接种10μg(CHO细胞)乙肝疫苗免疫后均能产生良好效果,建议接种乙肝疫苗时不应当将感染人群排除在外。
Objective To understand the effect of vaccination against hepatitis B (CHB) in anti-HBc positive pupils and control subjects and to analyze the immune response against hepatitis B (HBV) in naturally-infected human beings. Methods 125 cases of naturally infected patients with hepatitis B virus (anti-HBc positive) were selected by the method of individual matched case-control study. The same class was selected according to the ratio of 1: 1. The same sex, same age and no hepatitis B virus were infected. Vaccine 125 people as a control group for serological observation. Results The total positive conversion rate of antibody was 85.6%, of which 80.8% in the experimental group and 90.4% in the control group. The geometric mean concentration (GMC) of the experimental group was 7087.02 IU / ml, and the control group was 6517.88 IU / ml. There was a significant difference in antibody positive rate between the two groups at one month after immunization (χ2 = 4.67,0.01
0.05), 9-10 years old (χ2 = 1.55, P> 0.05) Corrected), P> 0.05). Conclusion Inoculation of hepatitis B vaccine and non-infected hepatitis B virus is better. The geometric mean concentration of experimental group higher than the control group may be related to immune memory. The experimental group and control group of children vaccinated with 10μg (CHO cells) of hepatitis B vaccine can produce good results after immunization, hepatitis B vaccine should not be excluded from the infected population should be excluded.