医护人员和军人应急快速乙肝免疫研究

目的观察快速乙肝疫苗接种方案对医护人员和军人应急乙肝免疫的效果。方法健康受试者分两组，组1512名军人，年龄26．5（18—48）a。对照组（组2）424名实习医师、护士等，年龄23，2（18-49）a。组1按快（d0、d7、d14）程序、组2按标准（mo 0、mo l、mo 6）程序三角肌内接种20ggCHO乙肝疫苗。于首针接种后lmo、3mo、7mo、12mo、24mo和36mo分别查抗．HBs滴度等。结果组1全程接种完成率（6．7％）明显高于组2（72．9％）（P〈0．01）。首针接种后l、3mo组1抗．HBs阳转率（67．0％和97．6％）明显高于组2（17．9％和42．8％）（P〈0．01），7。36mo各时段者两组接近（P〉0．05）：lmo、3mo时段组l血清抗．HBs保护率（63．5％、94、7％）显著高于组2（7．8％和31．2％）（P〈0．01）。组1lmo、3mo血清抗-HBs几何平均滴度分别为121．7IU／L和131．2IU／L，显著高于组2（15．4IU／L和41．5IU／L）（P〈0．01）。对标准程序无反应者予快程序接种后抗-HBs阳转率（73．2％）亦明显高于重复标准程序者（25．8％）（P〈0，01）。有乙肝家族吏者免疫反应率明显低于无乙肝家族史者（P〈0．01）。结论快程序方案全程接种完成率高；抗-HBs阳转和几何平均滴度（GMT）峰值出现早；对标准程序无反应者亦有较好效果。

A Compared Study on conventional and accelerated immunization schedules for rapid protection against hepatitis B

Objective To study accelerated immunization schedules for rapid protection against hepatitis B. Methods Normal subjects were consecutively collected and divided into two groups. Groupl 512 army men aged 26.5 （18-48） years old. Control group （Group2） consist of 424 aged 23.2 （18-49） years old. 20ug recombinant hepatitis B vaccine was vaccinated intradeltoideusly by accelerated schedule （on day 0,7 and 14） for Group 1 and standard schedule （on mo 0, land 6） for Group2. HBV-marks and anti -HBs titers were tested at 1,3,7,12,24 and 36 month after first dose. Results The completion rates in group 1 （96.7%） were markedly higher than in group2 （72.9%） （P〈0.01）. The seroconversion rate and the effective protection rate of anti-HBs 1 and 3 month after first dose were significantly higher in groupl （67.0%, 97.6% and 63.5% and 94.7%, respectively） than in group2 （17.9%, 42.8% and 7.8%, 31.2%, respectively） （P〈0.01）. The geometric mean titers （GMT） of anti-HBs were markedly higher in groupl （121.7 IU/L and 131.2IU/L） than in group2 （15.4 IU/L and 41.5 IU/L） （P〈0.01） 1 and 3 month after first dose. The seroconversion rate o f anti-HBs were also markedly higher with accelerated schedule （73.2%） than the standard schedule （25.8%） in those who had no response to standard schedule （P〈0.01）. Conclusions The accelerated schedule is simple and effective, with a higher completion rate, higher and earlier seroconversion, and appearance of peak GMT of anti-HBs than the standard schedule. For those who have no response to standard schedule it is also more effective.