成人乙型肝炎疫苗初免低应答后加强免疫及影响因素分析

山东大学学报(医学版) ›› 2012, Vol. 50 ›› Issue (11): 126-.

成人乙型肝炎疫苗初免低应答后加强免疫及影响因素分析

吕静静1,2，颜丙玉2，陈士玉3，徐爱强2，刘甲野2，冯艺2，
龚晓红4，崔富强4，梁晓峰4，张丽2，王健1

1.山东大学卫生管理与政策研究中心，济南 250012；
2.山东省疾病预防控制中心山东省传染病预防控制重点实验室，济南 250014；
3.章丘市疾病预防控制中心，山东章丘 250200； 4.中国疾病预防控制中心免疫规划中心，北京 100050

收稿日期:2012-07-21 出版日期:2012-11-10 发布日期:2012-11-10
通讯作者: 张丽(1973- )，女，博士，副主任医师，主要从事疫苗可预防疾病控制策略研究。 E-mail：zl9127@163. com 王健(1966- )，男，博士，教授，主要从事卫生政策研究。 E-mail：wangjiannan@sdu.edu.cn
作者简介:吕静静(1977- )，女，博士研究生，主管医师，主要从事疫苗可预防疾病控制策略研究。 E-mail: lvjingjing7257@163.com
基金资助:
国家“十一五”科技重大专项(2008ZX10002001，2009ZX10002028)；山东省医药卫生青年基金(2009QZ017)

Antibody response and the influencing factors after revaccination with
three doses of hepatitis B vaccines among lowresponse adults

L Jing-jing1,2， YAN Bing-yu2， CHEN Shi-yu3， XU Ai-qiang2， LIU Jia-ye2， FENG Yi2，
GONG Xiao-hong4， CUI Fu-qiang4， LIANG Xiao-feng4， ZHANG Li2， WANG Jian1

1． Center for Health Management and Policy, Shandong University， Jinan 250012， China；
2. Shandong Center for Disease Control and Prevention， Shandong Provincial Key Laboratory of
Infectious Disease Control and Prevention, Jinan 250014, China；
3. Zhangqiu Center for Disease Control and Prevention， Zhangqiu 250200, Shandong, China；
4. Chinese Center For Disease Control And Prevention， Beijing 100050， China

Received:2012-07-21 Online:2012-11-10 Published:2012-11-10

摘要/Abstract

摘要：

目的比较成人HepB初免低应答者使用4种HepB进行3剂次加强免疫后antiHBs应答情况及影响因素。方法将低应答的18~49岁成人随机分4组，分别用10μg HepB-SC、10μg HepB-HP、20μg HepB-SC和20μg HepB-CHO，于0-1-6月进行3剂次加强免疫，对其进行问卷调查并于第3剂次后1月采集血标本，采用CMIA法检测anti-HBs。比较各组抗体应答情况，采用多因素回归分析其影响因素。结果免后总抗体阳转率为78.25%、10μg HepB-SC组、10μg HepB-HP组、20μg HepB-SC组和20μg HepB-CHO组分别为70.18 %、78.79%、77.34%和84.62%，有统计学差异(P=0.004)；总抗-HBs GMC为443.92mIU/mL，4组分别为297.03、435.21、445.76和604.64mIU/mL，亦有统计学差异(P<0.001)。多因素分析显示，初免抗体水平、疫苗种类、加强免疫疫苗种类与加强免疫后抗体阳转率和GMC有关。结论 HepB低应答成人3剂次加强免疫可获得较好抗体应答；20μg HepBCHO效果好于10μg HepBSC。

关键词: 成人；乙型肝炎疫苗；低应答者；加强免疫

Abstract:

Objective To evaluate the antibody response and influencing factors after revaccination with 3 doses of 4 types of hepatitis B vaccines among low-response adults. Methods The adults aged from 18 to 49 years old who were low response to the primary hepatitis B vaccine were randomly divided into 4 groups and revaccinated with one of the following types of hepatitis B vaccines at 0-1-6 schedule respectively: 10μg hepatitis B vaccine made by recombinant deoxyribonucleic acid techniques in Saccharomyces Cerevisiae (HepB-SC), 20μg HepB-SC, 10μg hepatitis B vaccine made by recombinant deoxyribonucleic acid techniques in Hansenula Polymorpha (HepBHP) and 20μg hepatitis B vaccine made by Chinese hamster ovary cell (HepB-CHO). Questionnaire survey was made and blood samples were drawn from each person one month after the third dose. Hepatitis B virus surface antigen (Anti-HBs) were detected by the CMIA method. Influencing factors on antibody response were compared and analyzed by the multiple regression analysis. Results The total rate of anti-HBs seroconversion was 78.25%. The rates of anti-HBs seroconversion were 70.18%, 78.79%, 77.34% and 84.62% in the 10μg HepB-SC group, the 10μg HepB-HP group, the 20μg HepB-SC group and the 20μg HepB-CHO group respectively and the difference was statistically significant(P=0.004). The total corresponding geometric mean concentration (GMC) of anti-HBs was 443.92mIU/mL. The GMCs of anti-HBs of 4 groups were 297.03mIU/mL, 435.21mIU/mL, 445.76mIU/mL and 604.64mIU/mL. The GMCs were also significantly different by the groups(P<0.001). The multivariate analysis showed that the antibody level and the vaccine type for the primary immunization, and the vaccine type for the revaccination were related to the antibody response after the revaccination. Conclusion A good antibody response could be achieved by revaccination with 3 doses of hepatitis B among the low-response adults. The antibody response of 20μg HepB-CHO is better than 10μg HepB-SC.

Key words: Adult; Hepatitis B vaccine; Low-respond; Revaccination

中图分类号:

R186

吕静静1,2，颜丙玉2，陈士玉3，徐爱强2，刘甲野2，冯艺2，龚晓红4，崔富强4，梁晓峰4，张丽2，王健1. 成人乙型肝炎疫苗初免低应答后加强免疫及影响因素分析[J]. 山东大学学报(医学版), 2012, 50(11): 126-.

L Jing-jing1,2， YAN Bing-yu2， CHEN Shi-yu3， XU Ai-qiang2， LIU Jia-ye2， FENG Yi2，GONG Xiao-hong4， CUI Fu-qiang4， LIANG Xiao-feng4， ZHANG Li2，. Antibody response and the influencing factors after revaccination with
three doses of hepatitis B vaccines among lowresponse adults[J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2012, 50(11): 126-.

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