遂宁市乙肝疫苗接种控制儿童乙肝感染效果分析

目的了解乙肝疫苗纳入免疫规划接种后儿童乙肝免疫与感染发病状况,评价现阶段预防控制儿童乙肝效果。方法单纯随机抽样采集新生儿全程接种乙肝疫苗的3～7岁儿童血清1677份,酶联免疫吸附试验（ELISA）检测乙肝表面抗原（HBsAg）,固相放射免疫法（RIA）检测乙肝表面抗体（抗-HBs）,利用报告乙肝发病和疫苗接种率数据进行综合分析评价。结果1677名儿童HBsAg阳性率为1.8%,其中城市、农村分别是1.58%、2.1%,男、女分别是1.62%、1.97%;3～7岁分别为1.23%、1.5%、2.02%、1.74%和2.43%。抗-HBs阳性保护率为55.1%,其中城市、农村分别是60.4%、47.08%,男、女分别是55.44%、54.74%,3～7岁分别为66.67%、59.76%、59.25%、44.34%和45.9%。对应1～7岁出生队列,2000-2006年乙肝疫苗接种率的逐年增高与乙肝发病率、HBsAg阳性率呈负相关（rs=-0.821,P〈0.05;rs=-0.866,P〈0.05）,而与抗-HBs保护率呈正相关（rs=0.920,P〈0.05）。结论实施新生儿乙肝疫苗免疫规划接种有效降低了乙肝感染率与发病率,新生儿接种疫苗后随年龄增长其保护率有所下降。

Effects of Hepatitis B Vaccine to Prevent HBV Infection in Children in Suining

Objective To survey the immunity level and infection status of HBV in children after hepatitis B vaccination was included in immunization program and evaluate the prevention and control of hepatitis B in children. Methods A total of 1 677 blood samples were taken from randomly selected children aged 3 -7 years with fully hepatitis B vaccination. HBsAg detection was conducted by ELISA, and anti - HBs detection was conducted by RIA. Comprehensive analysis and evaluation were performed on the incidence data of hepatitis B and vaccination rate of hepatitis B vaccine. Results The positive rate of HBsAg in 1 677 children was 1.8% （1.58% in urban area and 2. 1% in rural area, 1.62% in males and 1.97% in females）, and the positive rates of HBsAg in different aged children were 1.23% （3 years old）, 1.5% （4 years old）, 2. 02% （5 years old）, 1.74% （6 years old）, and 2. 43% （7 years old） respectively. The positive rate of anti - HBs in 1 677 children was 55. 10% （60. 40% in urban area and 47.08% in rural area, 55.44% in males and 54. 74% in female）, and the positive rate of anti-HBs in different aged children were 66. 67% （3 years old）, 59. 76% （4 years old）, 59.25% （5 years old）, 44. 34% （6 years old）, and 45.9% （7 years old） respectively. In the birth cohort of aged 1-7 years, the increase of hepatitis B vaccination was correlated negatively with the incidence rate of hepatitis B and the positive rate of HBsAg （rs=-0. 821, P〈0.05, rs=-0.866, P〈0.05）, and correlated positively with the positive rate of anti- HBs during the 2000-2006 （ rs = 0. 920, P 〈 0. 05 ）. Conclusion The implementation of hepatitis B vaccination in the new born reduced the infection rate and incidence rate of HBV effectively, but the protection by vaccination to the new born would decreased as getting older.