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目的评价北京市儿童进行乙肝疫苗加强免疫接种后抗-HBs的应答反应水平。方法采取多阶段整群系统抽样选择已进行乙肝疫苗初免的3~12岁儿童,采用固相放射免疫(SPRIA)方法,检测血清HBsAg、抗-HBs和抗-HBc水平,其中抗-HBs<10 Iu/L者进行不同剂量的己肝疫苗加强免疫,观察加强免疫后的抗-HBs。结果2 491名3~12岁儿童的抗-HBs阴性率为48.25%(CI%=35.15~64.26);对其中726名儿童进行己肝疫苗加强免疫后,接种2.5和5μg疫苗的儿童抗-HBs的阳转率分别为90.6%和90.9%,GMT分别为85.69和87.59 Iu/L,(χ2=0.02,P=0.89;t=0.36,P=0.72)。加强免疫后4~5周,平均抗-HBs的阳转率为92.8%,GMT为84.55 Iu/L;免后6~22周采血,平均抗-HBs的阳转率为86.66%,GMT为91.39 Iu/L,2个时间段的抗-HBs的阳转率差异有统计学意义(χ2=7.47,P=0.006)。结论3~12岁完成乙肝疫苗基础免疫的儿童,在抗体消失后给予一定剂量的乙肝疫苗进行加强免疫,其抗-HBs反应良好,表明机体存在对乙肝病毒有回忆反应,可能是维持乙肝疫苗长期保护效果的原因之一。
Objective To evaluate the response level of anti-HBs in children in Beijing after intensive immunization with hepatitis B vaccine. Methods A multistage cluster system was used to select the children aged 3 to 12 years who had been given hepatitis B vaccine for initial immunization. The serum levels of HBsAg, anti-HBs and anti-HBc were detected by solid phase radioimmunoassay (SPRIA) 10 Iu / L were given different doses of hepatitis B booster immunization, observed after boosting anti-HBs. Results The negative rate of anti-HBs in 2 491 children aged 3 to 12 years was 48.25% (CI% = 35.15-64.26). After 726 children were boosted with hepatitis B vaccine, anti-HBs The positive conversion rates were 90.6% and 90.9%, respectively. The GMTs were 85.69 and 87.59 Iu / L, respectively (χ2 = 0.02, P = 0.89; t = 0.36, P = 0.72). The average anti-HBs positive rate was 92.8% and the GMT was 84.55 Iu / L after 4 to 5 weeks after booster immunization. The average anti-HBs positive rate was 86.66% and the GMT was 91.39 Iu / L, two time periods of anti-HBs positive rate difference was statistically significant (χ2 = 7.47, P = 0.006). Conclusions In children aged 3 to 12 years who completed the basic immunization of hepatitis B vaccine, a certain dose of hepatitis B vaccine was given after the disappearance of antibody to boost immunity, and the anti-HBs response was good, indicating that the body has memory recall on hepatitis B virus, which may be to maintain hepatitis B vaccine for a long time One of the reasons to protect the effect.