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我们在北京10个区县共计703.2万人口的地区进行了乙肝疫苗大范围应用研究。结果表明:(1)对HBsAg阳性孕妇,HBeAg阴性者的新生儿仅用30—30—10疫苗即可100%得到保护。(2)对HBeAg阳性者的新生儿单用大剂量疫苗(30—30—10)保护率仅为82.79%;加1针HBIG,保护率可提高到91.98%,但产生无抗体应答和低应答的比例较高(9.68%);而加2针HBIG,将疫苗剂量减至20—20—20的免疫方案,保护率达97.13%,未见产生无应答者,经综合比较判为最佳免疫方案。(3)对HB-sAg阴性产妇新生儿的主动免疫30—10—10和20—10—10均优于10—10—10,提示首次接种较大剂量疫苗是必要的(P<0.001)。(4)对新生儿实行全免和只给HBsAg阳性产妇新生儿免疫均可阻断母婴传播,但后者不能预防婴幼时期的水平传播,故应对新生儿实行全免。(5)乙肝疫苗与计划免疫“四苗”同时应用无免疫干扰作用,可以联合免疫。
We conducted a large-scale application of hepatitis B vaccine in a total of 70.32 million people in 10 districts and counties in Beijing. The results showed that: (1) for HBsAg positive pregnant women, HBeAg-negative newborns can be 100% protected with only 30-30-10 vaccine. (2) The protection rate of newborns with HBeAg-positive neonates was only 82.79% when using high-dose vaccine (30-30-10); with 1-HBIG, the protection rate could be increased to 91.98%, but there was no antibody response or low response (9.68%). However, with 2-dose HBIG, the vaccine dose was reduced to 20-20-20 and the protection rate was 97.13%. No immune response was found and the best immunization Program. (3) The active immunization of newborns with HB-sAg negative mothers was better than 10-10-10 at 30-10-10 and 20-10-10, suggesting that the first dose of larger dose vaccine is necessary (P <0.001). (4) Immunization of newborns to all newborns and newborns only to HBsAg-positive mothers can block mother-to-child transmission, but the latter can not prevent horizontal transmission in infants and young children. (5) Hepatitis B vaccine and immunization “Four seedlings” at the same time the application of immune interference, can be combined immunization.