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目的:探索新生儿乙肝标志物模式和接种乙肝疫苗后的免疫状态,分析新生儿免疫状态在30个月以内的变化和影响因素。方法:选取326例30个月以内婴幼儿,188例7～30个月完成初次全程免疫接种婴幼儿。采用酶联免疫法对各年龄段婴幼儿乙肝5项指标进行测定。同时对0～1个月新生儿母亲的孕期检查进行回顾性分析。结果:受检婴幼儿的乙肝五项指标中,单纯抗-HBs的阳性率在7～12个月达高峰,为93%,25～30个月时下降至65.3%。抗-HBc阳性所占比例在0～1个月的新生儿中最高,随年龄的增长比例降低。0～1个月的新生儿与母亲乙肝5项模式中各抗体的阳性率比较差异无统计学意义,其中母亲为HBsAg阳性的新生儿,抗-HBc的阳性率为100%。结论:全程接种乙肝疫苗结束后1个月及在25个月后都应及时检测乙肝标志物,提高乙肝疫苗接种失败率及抗-HBs水平衰减的检出,以便及时复种。对于母亲是乙肝病毒携带者的婴幼儿,应在出生时、全程免疫后1个月、25个月时进行乙肝标志物的检查,以检测新生儿阻断的效果及乙肝标志物的动态变化。
OBJECTIVE: To explore the pattern of neonatal hepatitis B markers and immune status after hepatitis B vaccination and analyze the changes and influencing factors of neonatal immune status within 30 months. Methods: 326 infants and young children within 30 months were selected and 188 infants were immunized with 188 infants for 7 to 30 months. Enzyme-linked immunosorbent assay was used to determine 5 indicators of hepatitis B in infants and children of all ages. At the same time, 0 ~ 1 months pregnant mothers newborn examination for retrospective analysis. Results: Among the five indicators of hepatitis B in infants tested, the positive rate of anti-HBs was the highest in 7-12 months (93%) and decreased to 65.3% (25-30 months). The proportion of anti-HBc positive in 0 to 1 month of neonates in the highest, with increasing proportion of age decreased. There was no significant difference in the positive rate of each antibody among 5 months of newborns and mothers with hepatitis B in 0 ~ 1 month. The positive rate of anti-HBc was 100% in mothers with HBsAg-positive mothers. Conclusion: Hepatitis B markers should be tested in one month and 25 months after the whole course of Hepatitis B vaccination, so as to increase the failure rate of hepatitis B vaccination and detect the decay of anti-HBs in order to timely re-seed. For infants and young children whose mothers are carriers of hepatitis B virus, hepatitis B markers should be examined at birth, one month and 25 months after the full immunization to detect neonatal blockade and the dynamic changes of hepatitis B markers.