补充维生素A对婴幼儿乙肝疫苗再免疫效果的促进作用

目的 观察补充维生素A(VA)对婴幼儿乙型病毒性肝炎(简称乙肝)疫苗再免疫效果的影响.方法 于2008年10月至2009年3月间,招募山东临沂某农村地区所有按国家计划免疫常规全程接种过乙肝疫苗的7～36月龄婴幼儿,检测其血清乙肝表面抗体(抗-HBs)浓度,对其中100名血清抗-HBs水平较低的婴幼儿进行随机(随机数字表法)、双盲、安慰剂对照的VA干预实验.干预组(50名)采用市售浓缩鱼肝油作为VA补充剂,补充期3个月,每15天补充1次,每次0.5 g浓缩鱼肝油[含25 000 IU VA和2500 IU维生素D2(VD2)],共补充6次;对照组(50名)给予等体积玉米油.在干预实验开始后第30和第60天,给婴幼儿进行乙肝疫苗再免疫接种,第90天采集婴幼儿血清样本.用高效液相色谱法(HPLC)测定干预实验前后婴幼儿血清视黄醇浓度.用电化学发光免疫分析法(ECLIA)测定血清抗-HBs水平.结果 共有74名婴幼儿完成干预实验,实验组和对照组各37名.干预后,干预组和对照组儿童的血清视黄醇浓度分别为(404.1±123.1)、(240.8±92.8)μg/L(t=6.441,P＜0.01);两组儿童的血清抗-HBs水平分别为(2737.2±2492.6)和(1199.7±2141.6)U/L(t=2.846,P＜0.01).干预组无乙肝疫苗弱、无应答情况(0/37),对照组乙肝疫苗弱、无应答率为10.81%(4/37)(x2=4.229,P=0.040).结论 补充VA可提高儿童乙肝疫苗再免疫后血清抗-HBs水平.

Abstract：

Objective The objective of this study was to observe the interventional effect of cod liver oil supplementation on re-vaccination to hepatitis B virus (HBV) among infants and young children. Methods All 7 -36 months old infants and young children, who had been vaccinated with obligatory HBV vaccines routinely by the national technical and administrative procedures for HBV vaccination on children of China, were convened among villages in Linyi, Shandong province, from October 2008 to March 2009. After detection of serum anti-HBV, one hundred children with lower serum anti-HBV were picked out for the randomized, double blinded, placebo controlled vitamin A supplementation study. The children in the intervention group (50 subjects) took 0. 5 g condensed cod liver oil ( containing 25 000 IU vitamin A and 2500 IU vitamin D2 ) every 15 days for six times. The children in the control group (50 subjects) were given corn oil with same volume. All children were re-vaccinated at the 30th and the 60th day of the experiment. The serum samples were collected from each child at the 90th day of the experiment. Retinol concentration in serum samples was analyzed with HPLC method before and after the intervention. The levels of serum anti-HBs were detected by the electro-chemi-luminescence immunoassay (ECLIA) .Results Total 74 children finished the supplemental experiment and blood collection,37 subjects in each group, respectively. After intervention, the serum retinol level in the experimental and control group were ( 404. 1 ± 123. 1 ) and ( 240. 8 ± 92. 8 ) μg/L ( t = 6. 441, P ＜ 0. 01 ), respectively. The serum anti-HBs levels in the experimental and control group were( 2737.2 ± 2492.6 )and( 1199. 7 ± 2141.6 )U/L ( t =2. 846, P ＜ 0. 01 ), respectively. The rate of weak or no-answer case in experimental and control groups was 0. 00% ( 0/37 ) and 10. 81% ( 4/37 ) ( x2 = 4. 229, P = 0. 040), respectively. Conclusion The results showed that vitamin A supplementation might enhance the re-vaccination reaction against HB vaccine in infants and young children.

Interventional effect of vitamin A supplementation on re-vaccination to hepatitis B virus among rural infants and young children in China

Objective The objective of this study was to observe the interventional effect of cod liver oil supplementation on re-vaccination to hepatitis B virus (HBV) among infants and young children. Methods All 7 -36 months old infants and young children, who had been vaccinated with obligatory HBV vaccines routinely by the national technical and administrative procedures for HBV vaccination on children of China, were convened among villages in Linyi, Shandong province, from October 2008 to March 2009. After detection of serum anti-HBV, one hundred children with lower serum anti-HBV were picked out for the randomized, double blinded, placebo controlled vitamin A supplementation study. The children in the intervention group (50 subjects) took 0. 5 g condensed cod liver oil ( containing 25 000 IU vitamin A and 2500 IU vitamin D2 ) every 15 days for six times. The children in the control group (50 subjects) were given corn oil with same volume. All children were re-vaccinated at the 30th and the 60th day of the experiment. The serum samples were collected from each child at the 90th day of the experiment. Retinol concentration in serum samples was analyzed with HPLC method before and after the intervention. The levels of serum anti-HBs were detected by the electro-chemi-luminescence immunoassay (ECLIA) .Results Total 74 children finished the supplemental experiment and blood collection,37 subjects in each group, respectively. After intervention, the serum retinol level in the experimental and control group were ( 404. 1 ± 123. 1 ) and ( 240. 8 ± 92. 8 ) μg/L ( t = 6. 441, P ＜ 0. 01 ), respectively. The serum anti-HBs levels in the experimental and control group were( 2737.2 ± 2492.6 )and( 1199. 7 ± 2141.6 )U/L ( t =2. 846, P ＜ 0. 01 ), respectively. The rate of weak or no-answer case in experimental and control groups was 0. 00% ( 0/37 ) and 10. 81% ( 4/37 ) ( x2 = 4. 229, P = 0. 040), respectively. Conclusion The results showed that vitamin A supplementation might enhance the re-vaccination reaction against HB vaccine in infants and young children.