新生儿黄疸逾月未退对接种乙型肝炎疫苗的影响

目的探讨新生儿黄疸延迟、逾月不退时接种乙肝疫苗（HepB）所产生的各种影响。方法采用追踪调查、动态了解新生儿黄疸延迟,逾月未退时接种HepB后的反应特征;用放射免疫法（RIA）定量检测乙肝病毒表面抗体（抗-HBs）水平。结果调查18月龄～36月龄儿童615例,均为早期新生儿黄疸延迟,及时或推后全程接种HepB者,抗-HBs阳性率平均86.1%。两组之间的抗-HBs阳性率差异有统计学意义,即新生儿黄疸未退期接种HepB平均抗-HBs阳性率80.9%,新生儿黄疸退净期接种HepB平均抗-HBs阳性率92.8%。结论新生儿黄疸逾月未退接种HepB可能是新生儿HepB免疫接种失败的一个不可忽视的原因。新生儿黄疸逾月未退应推迟HepB的第2剂次接种时间。

The influence of neonatal jaundice on HBV vaccination

Objective To study serum antibody conversion after the second dose of HBV vaccination in infants with neonatal jaundice.Methods Among 615 infants with neonatal jaundice,308 of which were vaccinated with standard schedule and the others were vaccinated with the second dose of HBV vaccine after the clearance of jaundice.The serum anti-HBs concentration was tested by RIA method.Results The anti-HBs positive rate was 86.1% on average.The proportion of anti-HBs serum conversion was significantly lower in the group with the standard schedule of the second dose of HBV vaccine（80.9%）than that in the group with the second dose of HBV vaccination after the clearance of neonatal jaundice（91.8%,P〈0.05）.Conclusion The neonatal jaundice was associated with the failure of HBV vaccination.The result suggested that the second dose of HBV vaccination should be postponed in infants with delayed clearance of neonatal jaundice.