婴儿期的年龄别体重与幼儿期乙肝疫苗应答的关联

目的 探讨婴儿期的年龄别体重与幼儿期儿童乙肝疫苗应答是否有关联。方法 2013年9月~2015年6月在新疆某三甲医院纳入检测乙肝两对半并完成0~1~6全程接种的儿童，并调查回顾其疫苗接种信息以及0~12月龄身高体重、父母一般情况、母亲孕期、儿童出生情况等。使用年龄别体重及其Z评分（weight for age Z score，WAZ）、年龄别体重偏离情况作为评价体格生长的指标，分析与乙肝疫苗应答的关联。结果 965名儿童纳入研究，男孩490人，女孩475人；平均年龄（1.34±0.56）岁，乙肝抗体阴性儿童占15.23%（147/965），抗体阴性组与阳性组父母一般情况、母亲孕期、儿童出生情况比较，差异均无统计学意义（均有P>0.05）。两组儿童1、3、6、9月龄别体重差异均有统计学意义（均有P<0.05），阴性组高于阳性组。两组儿童1、3、6年龄WAZ、体重偏离情况差异均有统计学意义（均有P<0.05）；1月龄（OR=3.409，95%CI:2.199~5.286）、3月龄（OR=5.339，95%CI:3.128~9.113）、6月龄（OR=5.106，95%CI:2.910~8.958）超重者相对正常者的乙肝疫苗不应答率较高；1月龄（OR=3.554，95%CI:2.249~5.616）、3月龄（OR=5.785，95%CI:3.271~10.232）、6月龄（OR=4.486，95%CI:2.642~7.619）体重右偏离者相对正常者的乙肝疫苗不应答率较高。结论 接种期（0~6月龄）体重对乙肝疫苗应答有影响，体格生长过快影响乙肝疫苗应答。

Immune response to hepatitis B vaccine in infant associated with infant weight-for-age

Objective To investigate the association between infant immune response to hepatitis B vaccine and infant weight-for-age. Methods All infants with a complete HBV vaccination from the top three hospitals in Xinjiang province were detected for hepatitis B infection on the first time they came to the hospital from September 2013 to June 2015. A self-designed questionnaire was used to collect data on vaccination details, 0-12 months height and weight information, general situation of parents, mother information during pregnancy, information of birth, and other information. Weight-for-age Z score (WAZ) and weight deviation were used for the growth and physiology index assessment to analyze its association with immune response to hepatitis B vaccine. Results 490 boys and 475 girls of total 965 children with a mean age of (1.34±0.56) were included in the study, among which HBV antibody-negative children accounted for 15.23% (147/965). There was no significant difference in the general situation of parents, mother information during pregnancy, information of birth between group (-) and (+)(all P>0.05). Compared group (-) and (+) by 1,3,6 month weight, the difference was statistically significant (all P<0.05). Infants in group (-) were heavier than those in group (+). Compared group (-) and (+) by 1,3,6 month WAZ, weight deviation, the difference was statistically significant (all P<0.05). The OR of overweight relative to normal in 1 month was 3.409,95% CI:2.199-5.286, 3 month was 5.339,95% CI:3.128-9.113 and 6 month was 5.106,95% CI:2.910-8.958, overweight group had higher non-response rate compared with normal group. The OR of right-deviation to normal in 1 month was 3.554,95% CI:2.249-5.616, 3 month was 5.785,95% CI:3.271-10.232 and 6 month was 4.486,95% CI:2.642-7.619, overweight group had higher non-response rate compared with normal group. Conclusions The weight of 0-6 months (inoculation period) will affect the level of immune response to hepatitis B vaccine. The fast physical growth of infant have influence on the response to hepatitis B vaccine.