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目的评价婴儿接种乙型肝炎疫苗的效果。方法回顾性分析2002-2012年北京市顺义区母亲为乙肝表面抗原(HBsAg)阳性和母亲为HBsAg阴性的婴儿(普通婴儿)接种乙肝疫苗后的血清学资料。结果 224例母亲为HBsAg阳性的婴儿中,HBsAg阳性者5例,阳性率为2.2%;HBsAb阳性者204例。219例HBsAg阴性婴儿和165例普通婴儿的HBsAb阳性率分别为93.2%和99.4%。母亲HBsAg、HBeAg双阳性者、母亲单阳性者(HBsAg阳性)及母亲HBsAg阳性、HBsAg不详者,3组的免疫效果差异无统计学意义(P>0.05)。母亲HBsAg阳性婴儿免疫效果比普通婴儿差(P<0.01)。母亲为HBsAg阳性的婴儿接种10μg剂量进口疫苗和10μg剂量“搭配接种方案”的免疫效果均优于5μg国产疫苗(P<0.05)。母亲HBsAg阳性是阻碍婴儿HBsAb产生的影响因素(OR=0.086,P=0.035)。结论顺义区现行乙肝免疫策略对母亲为HBsAg阳性的婴儿免疫效果较理想,但较普通婴儿效果略差。
Objective To evaluate the effectiveness of infant hepatitis B vaccination. Methods The serological data of HBsAg positive mothers and HBsAg negative infants (normal babies) who received hepatitis B vaccine from Shunyi District in Beijing from 2002 to 2012 were retrospectively analyzed. Results Among the 224 HBsAg-positive mothers, 5 were positive for HBsAg and the positive rate was 2.2%. Another 204 were HBsAb-positive. The positive rates of HBsAb in 219 cases of HBsAg-negative infants and 165 cases of common infants were 93.2% and 99.4% respectively. There was no significant difference in the immune effects among the three groups (P> 0.05). The positive rates of HBsAg, HBeAg positive mother, single mother positive (HBsAg positive) and mother HBsAg positive, HBsAg unknown. The mothers with HBsAg positive infants had worse immune effects than the normal infants (P <0.01). Mother vaccinated HBsAg-positive infants with a dose of 10 μg and a dose of 10 μg were better than 5 μg domestic vaccines (P <0.05). Positive HBsAg mothers were the factors hindering the development of HBsAb in infants (OR = 0.086, P = 0.035). Conclusion The current immunization strategy of hepatitis B in Shunyi District is better than that of the normal babies.