深圳市龙岗区18711例1～14岁儿童血清乙肝表面抗体水平分析
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摘要
目的:了解深圳市龙岗区1~14岁儿童血清抗-HBs水平现况,为进行儿童抗-HBs水平监测及加强免疫决策提供依据。方法:选取2012年1月-2016年7月在深圳市龙岗区妇幼保健院儿童保健科健康体检并完成0、1、6个月基础免疫的18 711名1~14岁儿童作为研究对象,抽取静脉血3ml,采用ELISA法检测血清抗-HBs水平。结果:18 711名1~14岁儿童血清抗-HBs阳性率为59.25%;其中女童血清抗-HBs阳性率为61.39%,高于男童的57.57%,差异具有统计学意义(χ~2=27.93,P=0.000)。不同年龄组间儿童血清抗-HBs阳性率不同,差异具有统计学意义(χ~2=13 48.2,P=0.000)。幼儿组儿童血清抗-HBs阳性率最高为71.26%,在1岁左右达到78.65%;随后儿童血清抗-HBs阳性率随时间推移而下降,学龄前组儿童最低为48.67%。结论:龙岗区1~14岁儿童HBV感染流行趋势处于较低水平,但抗-HBs阳性率仅为59.25%,为规避儿童个体感染HBV的风险,需要加强儿童血清HBV感染的免疫监测,对于抗-HBs无/低应答儿童应再次免疫接种。
Objective To investigate the level status of serum anti-HBs in children aged from 1to 14 years old in Longgang District of Shenzhen city,and to provide basis for monitoring anti-HBs levels and strengthening children's immunity decision-making.Methods Totally 18711 children aged from 1to 14 years were enrolled in this study who had accepted the 0,1,6-month basic immunization in Longgang Maternal and Child Health Care Center from January2012 to July 2016,and the serum anti-HBs levels of them were detected by ELISA method.Results The positive rate of serum anti-HBs of the 18 711 children was 59.25%,and the rate of girls was 61.39%,higher than that of boys(57.57%),and there was statistically significant difference between girls and boys(χ~2=27.93,P=0.000).The positive rates of serum anti-HBs in different age groups were different,and there was statistically significant difference among different age groups(χ~2=1 348.2,P=0.000).The positive rate of infant group was the highest(71.26%),especially for the children aged 1year old(78.65%),and the positive rate was gradually decreased along with the increasing age of the children.So the positive rate of the preschool children was the lowest(only 48.67%).Conclusions The prevalence of HBV infection in children aged from 1to 14 years in Longgang District is at a low level,however,the positive rate of anti-HBs is only 52.95%,so it is necessary to strengthen the immunological monitoring of HBV infection and enhance revaccination for children whose anti-HBs were negative or weak positive to protect children from HBV infection.
Objective To investigate the level status of serum anti-HBs in children aged from 1to 14 years old in Longgang District of Shenzhen city,and to provide basis for monitoring anti-HBs levels and strengthening children's immunity decision-making.Methods Totally 18711 children aged from 1to 14 years were enrolled in this study who had accepted the 0,1,6-month basic immunization in Longgang Maternal and Child Health Care Center from January2012 to July 2016,and the serum anti-HBs levels of them were detected by ELISA method.Results The positive rate of serum anti-HBs of the 18 711 children was 59.25%,and the rate of girls was 61.39%,higher than that of boys(57.57%),and there was statistically significant difference between girls and boys(χ~2=27.93,P=0.000).The positive rates of serum anti-HBs in different age groups were different,and there was statistically significant difference among different age groups(χ~2=1 348.2,P=0.000).The positive rate of infant group was the highest(71.26%),especially for the children aged 1year old(78.65%),and the positive rate was gradually decreased along with the increasing age of the children.So the positive rate of the preschool children was the lowest(only 48.67%).Conclusions The prevalence of HBV infection in children aged from 1to 14 years in Longgang District is at a low level,however,the positive rate of anti-HBs is only 52.95%,so it is necessary to strengthen the immunological monitoring of HBV infection and enhance revaccination for children whose anti-HBs were negative or weak positive to protect children from HBV infection.
引文
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[13]荆庆,梁争论,王建峰,等.母亲乙型肝炎病毒表面抗原阴性婴儿接种重组乙型肝炎疫苗(酵母)后的抗体无应答分析[J].中国计划免疫,2007,13(3):219-221.
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[15]王继杰,文中兰,陈子君,等.新生儿乙型肝炎疫苗免疫后20年免疫效果研究[J].实用预防医学,2008,15(6):1831-1833.
[16]Bialek SR,Bower WA,Novak R,et al.Persistence of protection against hepatitis B virus infection among adolescents vaccinated with recombinant hepatitis B vaccine beginning at birth:a 15-year follow-up study[J].Pediatr Infect Dis J,2008,27(10):881-885.
[17]张志存.高中生乙肝疫苗免疫效果分析[J].河北医药,2010,32(4):482-483.
[18]朱渭萍,王远萍,费怡,等.上海市浦东新区不同人群乙肝病毒感染现状与免疫策略研究[J].中华疾病控制杂志,2014,18(2):112-116.
[19]陈德颖,于洋,杨静,等.威海市新生儿乙肝疫苗初免和低/无应答者在免疫效果分析[J].预防医学论坛,2012,18(1):5-6.
[20]刘和平.125名新生儿接种乙肝疫苗及低/无应答者再免疫效果分析[J].实用预防医学,2016,23(3):350-352.
[2]张艳彪.深圳市常住人口乙型病毒性肝炎血清流行病学调查[D].硕士论文,2012.
[3]沈立萍,杨进业,莫兆军,等.乙型肝炎重组酵母接种6~9年的人群免疫效果研究[J].应用预防医学,2006,12(3):129-132.
[4]翟如芳,邢秀生,王海娇,等.重组乙型肝炎疫苗(酵母)免疫后12年的抗体持久性研究[J].中国疫苗与免疫,2008,14(6):521-523.
[5]钟群,谌稳国,罗述斌.重组乙型肝炎疫苗在健康人群中的免疫效果及安全性评价[J].实用预防医学,2012,19(10):1491-1493.
[6]齐顺祥,张新江,张建立,等.重组乙型肝炎疫苗(中国仓鼠卵巢细胞)免疫12年的效果研究[J].中国疫苗和免疫,2010,16(1):1-4.
[7]WHO.Position Paper on Hepatitis B Vaccine[S].2009-10-02(10).
[8]Zhu CL,Liu P,Chen T,et al.Presence of immune memory andimmunity to hepatitis B virus in adults after neonatal hepatitis Bvaccination[J].Vaccine,2011,29(44):7835-7841.
[9]Wait S,Chen DS.Towards the eradication of hepatitis B in Tai-wan[J].Kaohsiung J Med Sci,2012,28(1):1.
[10]姚军,梁晓峰,陈永弟,等.乙型肝炎病毒高流行区儿童接种乙型肝炎疫苗5-16年免疫效果评价[J].中国疫苗和免疫,2011,17(4):294-298.
[11]Lu CY,Ni YH,Chiang BL,et al.Humoral and cellular immune responses to a hepatitis B vaccine booster 15-18years after neonatal immunization[J].J Infect Dis,2008,197(10):1419-1426.
[12]Jan CF,Chien YC,Chiu TY,et al.Determination of immune memory to hepatitis B vaccination through early booster response in college students[J].Hepatology,2010,51(5):1547-1554.
[13]荆庆,梁争论,王建峰,等.母亲乙型肝炎病毒表面抗原阴性婴儿接种重组乙型肝炎疫苗(酵母)后的抗体无应答分析[J].中国计划免疫,2007,13(3):219-221.
[14]郑徽,王富珍,陈园生,等.新生儿接种重组乙型肝炎疫苗(酵母)后低无应答率及影响因素分析[J].中国计划免疫,2007,13(4):303-305.
[15]王继杰,文中兰,陈子君,等.新生儿乙型肝炎疫苗免疫后20年免疫效果研究[J].实用预防医学,2008,15(6):1831-1833.
[16]Bialek SR,Bower WA,Novak R,et al.Persistence of protection against hepatitis B virus infection among adolescents vaccinated with recombinant hepatitis B vaccine beginning at birth:a 15-year follow-up study[J].Pediatr Infect Dis J,2008,27(10):881-885.
[17]张志存.高中生乙肝疫苗免疫效果分析[J].河北医药,2010,32(4):482-483.
[18]朱渭萍,王远萍,费怡,等.上海市浦东新区不同人群乙肝病毒感染现状与免疫策略研究[J].中华疾病控制杂志,2014,18(2):112-116.
[19]陈德颖,于洋,杨静,等.威海市新生儿乙肝疫苗初免和低/无应答者在免疫效果分析[J].预防医学论坛,2012,18(1):5-6.
[20]刘和平.125名新生儿接种乙肝疫苗及低/无应答者再免疫效果分析[J].实用预防医学,2016,23(3):350-352.