乙肝表面抗体衰减人群细胞免疫状态和影响因素分析

目的]探索乙肝疫苗接种人群免疫状态和乙肝表面抗体衰减的影响因素。方法]采用多阶段随机抽样的方法,在上海市卢湾区和松江区随机抽取600名既往全程接种乙肝疫苗的对象,将其中HBsAg、抗-HBc阴性且抗-HBs10 mIU/mL的293名对象作为乙肝表面抗体衰减组,抗-HBs≥10 mIU/mL的307名对象作为人群对照组,使用多因素非条件Logistic回归模型进行影响因素分析。从乙肝表面抗体衰减组中随机抽取30名对象作为实验研究组,检测细胞因子干扰素(IFN-γ)、白细胞介素(IL-4)和乙肝病毒脱氧核糖核酸(HBV-DNA)含量,按照1∶1配对原则,从人群对照组中随机抽取30名抗-HBs100 mIU/mL、性别相同、年龄±1岁的对象作为阳性对照组,检测IFN-γ和IL-4。结果]多因素非条件Logistic回归模型提示,免疫年限(OR=2.01)、牙科治疗史(OR=1.55)和婚姻状况(OR=13.17)与人群乙肝表面抗体衰减存在密切联系。细胞免疫检测提示,乙肝表面抗体衰减实验研究组对象的IFN-γ阳性细胞百分比和IL-4阳性细胞百分比均显著低于实验对照组。结论]乙肝表面抗体衰减者清除HBV的特异性细胞免疫可能和体液免疫一样均处于弱化状态,推行乙肝疫苗加强免疫策略应该是今后乙肝防治工作的重点。

Immunity status of hepatitis B vaccine immunized population and influence factors in anti-HBs declined group

Objective] To detect cellular immunity status of hepatitis B vaccine immunized population and explore influence factors in anti-HBs declined group. Methods] By multi-stage randomized sampling method we selected 600 immunized cases from Luwan and Songjiang districts,of which 293 cases with anti-HBs lower than 10 mIU/mL were as anti-HBs declined group and 307 cases with anti-HBs higher than 10 mIU/mL as control.Then we used multivariate unconditional Logistic regression to analyze the database.We selected 3...