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目的了解乙肝疫苗纳入免疫规划接种后儿童乙肝免疫与感染发病状况,评价现阶段预防控制儿童乙肝效果。方法单纯随机抽样采集新生儿全程接种乙肝疫苗的3～7岁儿童血清1677份,酶联免疫吸附试验(ELISA)检测乙肝表面抗原(HBsAg),固相放射免疫法(RIA)检测乙肝表面抗体(抗-HBs),利用报告乙肝发病和疫苗接种率数据进行综合分析评价。结果1677名儿童HBsAg阳性率为1.8%,其中城市、农村分别是1.58%、2.1%,男、女分别是1.62%、1.97%;3～7岁分别为1.23%、1.5%、2.02%、1.74%和2.43%。抗-HBs阳性保护率为55.1%,其中城市、农村分别是60.4%、47.08%,男、女分别是55.44%、54.74%,3～7岁分别为66.67%、59.76%、59.25%、44.34%和45.9%。对应1～7岁出生队列,2000-2006年乙肝疫苗接种率的逐年增高与乙肝发病率、HBsAg阳性率呈负相关(rs=-0.821,P<0.05;rs=-0.866,P<0.05),而与抗-HBs保护率呈正相关(rs=0.920,P<0.05)。结论实施新生儿乙肝疫苗免疫规划接种有效降低了乙肝感染率与发病率,新生儿接种疫苗后随年龄增长其保护率有所下降。
Objective To understand the status of hepatitis B immunization and infection in children immunized with hepatitis B vaccine and to evaluate the prevention and control of hepatitis B in children at this stage. Methods A total of 1677 serum samples were collected from 3 to 7-year-old children whose whole newborns were vaccinated with hepatitis B virus by simple random sampling. HBsAg and HBsAg were detected by enzyme-linked immunosorbent assay (ELISA) and real-time radioimmunoassay (RIA) Anti-HBs), using the report of hepatitis B incidence and vaccination rate data for comprehensive analysis and evaluation. Results The positive rate of HBsAg in 1677 children was 1.8%, which was 1.58% and 2.1% respectively in urban and rural areas, 1.62% and 1.97% in males and females respectively, and 1.23%, 1.5%, 2.02% and 1.74 % And 2.43%. The positive protection rate of anti-HBs was 55.1%, of which urban and rural areas were 60.4% and 47.08% respectively, male and female were 55.44% and 54.74% respectively, 66.67%, 59.76%, 59.25% and 44.34% And 45.9%. Corresponding to the cohorts of 1 to 7 years of age, the annual increase of hepatitis B vaccination rate from 2000 to 2006 showed a negative correlation with the incidence of hepatitis B and the positive rate of HBsAg (rs = -0.821, P <0.05; rs = -0.866, P < But positively correlated with anti-HBs protection rate (rs = 0.920, P <0.05). Conclusion The vaccination program of neonatal hepatitis B vaccination effectively reduces the infection rate and incidence of hepatitis B. The neonatal vaccination rate decreases with the increase of age after vaccination.