| 聂黎,庞星火,张政,马建新,刘秀颖,邱倩,梁妍,李倩,张卫.不同种类和剂量乙型肝炎疫苗成年人快速免疫效果观察[J].中华流行病学杂志,2017,38(9):1151-1155 |
| 不同种类和剂量乙型肝炎疫苗成年人快速免疫效果观察 |
| Effectiveness of rapid hepatitis B vaccination with different vaccine dosages and types in adults |
| 收稿日期:2017-01-04 出版日期:2017-09-09 |
| DOI：10.3760/cma.j.issn.0254-6450.2017.09.001 |
| 中文关键词: 乙型肝炎疫苗 免疫效果 快速免疫方案 |
| 英文关键词: Hepatitis B vaccine Effectiveness of immunization Rapid immunization schedule |
| 基金项目:国家科技重大专项（2009ZX10004903，2012ZX10004904，2012ZX10002001） |
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| 中文摘要: |
| 目的 探讨不同种类和剂量乙型肝炎（乙肝）疫苗（HepB）在成年人中的快速免疫效果。方法 在北京市朝阳区筛选≥ 20周岁、乙肝5项指标检测为阴性或单独核心抗体阳性者为接种对象，以社区为单位分成4组，按"0-1-2"免疫方案分别接种10、20 μg酒酿酵母乙肝疫苗（HepB-SCY）、20 μg中国仓鼠卵巢乙肝疫苗（HepB-CHO）、10 μg汉逊酵母乙肝疫苗（HepB-HPY）。全程接种1~2个月后采用化学发光法定量检测抗-HBs水平。结果 共有1 772名符合条件的研究对象完成疫苗接种和效果观察。平均年龄48.50岁，女性占62.75%。10、20 μg HepB-SCY组，20 μg HepB-CHO组和10 μg HepB-HPY组的抗-HBs阳转率和几何平均滴度（GMT）分别为79.49%、84.34%、82.50%、74.15%（P=0.005）和39.53、62.37、48.18、33.64 mIU/ml（P=0.025）；总体抗-HBs阳转率和GMT分别为79.01%和41.18 mIU/ml。4组研究对象抗-HBs水平均随年龄增长均呈下降趋势，组间抗-HBs的GMT的差异随年龄增大而缩小。logistic回归分析显示，控制了"是否单独核心抗体阳性"和"乙肝疫苗接种史"2个变量后，"接种疫苗种类和剂量"、"年龄"、"是否吸烟"均与抗-HBs有统计学关联。结论 "0-1-2"快速免疫方案中采用20 μg剂量仍能在中高年龄组人群中获得80%以上的阳转率，可作为"0-1-6"乙肝疫苗常规免疫程序的补充。 |
| 英文摘要: |
| Objective To evaluate the effectiveness of rapid hepatitis B vaccination with different vaccine dosages and types in adults. Methods Adults who were aged ≥ 20 years, negative in the detections of 5 HBV serum markers or only anti-HBc positive were selected from Chaoyang district of Beijing. They were divided into 4 community-based specific groups and given three doses of 10 μg HepB-SCY vaccine, 20 μg HepB-SCY vaccine, 20 μg HepB-CHO vaccine and 10 μg HepB-HPY vaccine respectively at month 0, 1, and 2. Their blood samples were collected within 1-2 months after completing the three dose vaccination to test anti-HBs level by using chemiluminesent microparticle immunoassay. A face to face questionnaire survey was conducted, and χ2 test, Mantel-Haensel χ2 test, Kruskal-Wallis rank test and multiple logistic regression analysis were performed. Results A total of 1 772 participants completed vaccination and observation. Their average age was 48.5 years, and 62.75% of them were females. The anti-HBs positive rates in the groups of 10 μg HepB-SCY, 20 μg HepB-SCY, 20 μg HepB-CHO and 10 μg HepB-HPY vaccines were 79.49%, 84.34%, 82.50% and 74.15%, respectively (P=0.005), and the geometric mean titers (GMT) were 39.53 mIU/ml, 62.37 mIU/ml, 48.18 mIU/ml and 33.64 mIU/ml respectively (P=0.025). The overall anti-HBs positive rate and GMT were 79.01% and 41.18 mIU/ml. The anti-HBs GMT of 4 groups declined with age. The differences in anti-HBs GMT among 4 groups minimized with age. The result of logistic modeling indicated that vaccine type and dosage, age and smoking were associated with anti-HBs statistically after controlling the variables of "only anti-HBc positive or not" and "history of hepatitis B vaccination". Conclusion Hepatitis B vaccination at dosage of 20 μg based on 0-1-2 month rapid schedule could achieved anti-HBs positive rates >80% in middle aged and old people, which can be used as supplement of 0-1-6 month routine schedule. |
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