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目的:调查住院新生儿接种首针重组酵母乙型肝炎(乙肝)疫苗后HBsAb滴度情况,并探讨其相关影响因素。方法:以2012-2014年我院的1 002例新生儿为研究对象,在出生后24h内接种首针乙肝疫苗。采用化学发光微粒子免疫分析法检测HBsAb滴度,并通过问卷调查收集相关资料。通过单因素方差分析及有序多分类Logistic回归模型分析新生儿HBsAb滴度的影响因素。结果:新生儿首针乙肝疫苗免疫后,HBsAb滴度<10mIU/ml者397例,10-99mIU/ml者294例,100-999mIU/ml者252例,≥1 000mIU/ml者59例;低无抗体率为67.0%,其中无抗体率为39.6%,低抗体率为29.4%。经综合考虑单因素分析和有序多分类Logistic回归分析,胎龄、母亲HBsAb滴度和母亲HBsAg这3个因素是新生儿HBsAb滴度的影响因素,其低无抗体的OR值分别为1.179(胎龄<32周)、8.906(母亲HBsAb<10mIU/ml)、4.203(母亲HBsAb 10-99mIU/ml)和3.134(母亲HBsAg阳性)。结论:胎龄<32周、母亲HBsAb<100mIU/ml和母亲HBsAg阳性新生儿首针乙肝疫苗后HBsAb滴度较低,应加强HBsAb滴度的监测。
OBJECTIVE: To investigate the HBsAb titers after in-hospital immunization of first-born recombinant yeast hepatitis B vaccine and explore the related factors. Methods: One hundred and two newborns in our hospital from 2012 to 2014 were enrolled in this study. The first dose of hepatitis B vaccine was given within 24 hours after birth. The chemiluminescence microparticle immunoassay was used to detect the HBsAb titer and the relevant data were collected through questionnaire. The influence factors of neonatal HBsAb titers were analyzed by one-way ANOVA and ordinal multi-classification Logistic regression model. Results: 397 cases of HBsAb titer <10mIU / ml, 294 cases of 10-99mIU / ml, 252 cases of 100-999mIU / ml and 59 cases of ≥1000mlU / ml of HBsAb after immunization with the first dose of hepatitis B vaccine The rate of non-antibody was 67.0%, in which the rate of non-antibody was 39.6% and the rate of low antibody was 29.4%. After comprehensive consideration of univariate analysis and ordered multi-classification Logistic regression analysis, gestational age, mothers HBsAb titers and mothers HBsAg were the influencing factors of neonatal HBsAb titers. The OR values of the non-antibody titers were 1.179 Gestational age <32 weeks), 8.906 (maternal HBsAb <10 mIU / ml), 4.203 (maternal HBsAb 10-99 mIU / ml) and 3.134 (maternal HBsAg positive). CONCLUSION: HBsAb titers should be monitored after gestational age <32 weeks, mothers HBsAb <100mIU / ml and mother’s HBsAg positive neonates with first-dose hepatitis B vaccine. HBsAb titers should be monitored.