CAJ | 학술논문

目的探讨成人乙型肝炎(乙肝)疫苗接种后无(弱)应答者不同方案再免疫的效果,以提高乙肝疫苗预防接种的保护率.方法采用随机、开放性的研究方法,对2年内至少完成1个标准乙肝疫苗免疫接种程序、复查HBV标志物均为阴性的健康人群,随机接受4种接种方案,按常规程序(0、1、6个月)在上臂三角肌予肌内注射.国产10 μg组73例,国产基因重组乙肝疫苗复种,每次剂量为10 μg;国产20 μg组69例,国产基因重组乙肝疫苗复种,每次剂量为20 μg;进口20 μg组70例,基因重组酵母乙肝疫苗(商品名:安在时)复种,每次剂量为20 μg;进口40 μg组48例,基因重组酵母乙肝疫苗,每次剂量为40 μg.在复种首针乙肝疫苗前及复种首针后第1、2、8、12个月采血检测抗-HBs.均数比较采用单因素方差分析,率的比较采用χ2检验.结果接种后8个月,国产20 μg、进13 20 μg、进口40 μg组抗-HBs阳性率最高,分别为68.1%、70.0%和77.1%,均高于国产10 μg组的53.4%(X2=21.465,P＜0.01).国产20 μg、进口20 μg、进口40 μg组随接种次数增加及时间延长,抗HBs阳性率有所增加,但差异无统计学意义,12个月时有所下降;国产10 μg组首次接种后1、2、8、12个月,抗HBs阳性率依次为8.2%、19.2%、53.4%和43.8%,差异有统计学意义(X2=53.07,P＜0.01).12个月时,国产20 μg、进口20 μg、进口40 μg组抗-HBs效价均高于国产10 μg组(F=7.551,P＜0.05).国产20 μg、进口20 μg、进口40 μg组不同时间点抗-HBs效价比较,差异无统计学意义.结论对乙肝疫苗无(弱)应答者复种疫苗仍能产生免疫应答,增加疫苗剂量可提高疗效.
목적 탐토성인을형간염(을간)역묘접충후무(약)응답자불동방안재면역적효과,이제고을간역묘예방접충적보호솔.방법채용수궤、개방성적연구방법,대2년내지소완성1개표준을간역묘면역접충정서、복사HBV표지물균위음성적건강인군,수궤접수4충접충방안,안상규정서(0、1、6개월)재상비삼각기여기내주사.국산10 μg조73례,국산기인중조을간역묘복충,매차제량위10 μg;국산20 μg조69례,국산기인중조을간역묘복충,매차제량위20 μg;진구20 μg조70례,기인중조효모을간역묘(상품명:안재시)복충,매차제량위20 μg;진구40 μg조48례,기인중조효모을간역묘,매차제량위40 μg.재복충수침을간역묘전급복충수침후제1、2、8、12개월채혈검측항-HBs.균수비교채용단인소방차분석,솔적비교채용χ2검험.결과접충후8개월,국산20 μg、진13 20 μg、진구40 μg조항-HBs양성솔최고,분별위68.1%、70.0%화77.1%,균고우국산10 μg조적53.4%(X2=21.465,P＜0.01).국산20 μg、진구20 μg、진구40 μg조수접충차수증가급시간연장,항HBs양성솔유소증가,단차이무통계학의의,12개월시유소하강;국산10 μg조수차접충후1、2、8、12개월,항HBs양성솔의차위8.2%、19.2%、53.4%화43.8%,차이유통계학의의(X2=53.07,P＜0.01).12개월시,국산20 μg、진구20 μg、진구40 μg조항-HBs효개균고우국산10 μg조(F=7.551,P＜0.05).국산20 μg、진구20 μg、진구40 μg조불동시간점항-HBs효개비교,차이무통계학의의.결론대을간역묘무(약)응답자복충역묘잉능산생면역응답,증가역묘제량가제고료효.
Objective To investigate the revaccination efficacy of different dosages of hepatitis B vaccine among adult non-and hyporesponders so as to improve the protection rate of hepatitis B vaccination.Methods The healthy adults who were immunized with hepatitis B vaccine at least one standard scheme in two years and negative for hepatitis B markers were enrolled in this randomized and open-label study.The hepatitis B vaccine was injected intramuscularly in the deltoid muscle on an upper arm according to routine schedule (month 0,1,6).The adults were randomly given four different dosages:73 in group A were given hepatitis B vaccine 10 μg (made in China) each time;69 in group B were given hepatitis B vaccine (made in China) 20 μg each time;70 in group C were given gene recombinant yeast hepatitis B vaccine (Engerix) 20 μg each time and 48 in group D were given gene recombinant yeast hepatitis B vaccine 40 μg each time.The serum anti-HBs was tested before and 1,2,8,12 months after the first injection.The comparison of means was done by one-factor analysis of variance and the comparison of rates was done by chi square test.Results The anti-HBs positive rates were the highest at months 8 of re-immunization in group B,C and D,which were 68.1%,70.0% and 77.1%,respectively,and were all higher than that in group A (53.4%)(χ2=21.465,P＜0.01).The anti-HBs positive rate increased in group B,C and D with increasing immunized times and over time,but there was no significant difference;it went down at 12 months after re-immunization.The anti-HBs positive rates at 1,2,8 and 12 months after re-immunization in group A were 8.2%,19.2%,53.4% and 43.8%,respectively and differences were significant (χ2=53.07,P＜0.01).The anti-HBs levels in group B,C and D were all higher than that of group A(F=7.551,P＜0.05) at month 12 of re-immunization.There were no significant differences of anti-HBs levels at different re-immunization time points in group B,C and D.Conclusion Revaecination of hepatitis B vaccine can induce immune responses and increasing dosages can improve the immune efficacy in non- and hyporesponders.