326例30个月以下婴幼儿乙肝标志物模式的调查分析

目的:探索新生儿乙肝标志物模式和接种乙肝疫苗后的免疫状态,分析新生儿免疫状态在30个月以内的变化和影响因素。方法:选取326例30个月以内婴幼儿,188例7～30个月完成初次全程免疫接种婴幼儿。采用酶联免疫法对各年龄段婴幼儿乙肝5项指标进行测定。同时对0～1个月新生儿母亲的孕期检查进行回顾性分析。结果:受检婴幼儿的乙肝五项指标中,单纯抗-HBs的阳性率在7～12个月达高峰,为93%,25～30个月时下降至65.3%。抗-HBc阳性所占比例在0～1个月的新生儿中最高,随年龄的增长比例降低。0～1个月的新生儿与母亲乙肝5项模式中各抗体的阳性率比较差异无统计学意义,其中母亲为HBsAg阳性的新生儿,抗-HBc的阳性率为100%。结论:全程接种乙肝疫苗结束后1个月及在25个月后都应及时检测乙肝标志物,提高乙肝疫苗接种失败率及抗-HBs水平衰减的检出,以便及时复种。对于母亲是乙肝病毒携带者的婴幼儿,应在出生时、全程免疫后1个月、25个月时进行乙肝标志物的检查,以检测新生儿阻断的效果及乙肝标志物的动态变化。

Investigation and analysis on modes of hepatitis B virus markers in 326 infants under 30 months

Objective:To explore the modes of hepatitis B virus(HBV) markers and immune state after inoculation of HBV vaccine in neonates,analyze the changes of immune state of infants under 30 months and the influencing factors.Methods:A total of 326 infants under 30 months were selected,188 infants completed primary immunization at 7-30 months after birth.ELISA was used to detect five HBV markers in infants in different age groups.Gestational examination of the mothers of 0-1-month-old neonates was analyzed retrospectively.Results:Among five HBV markers,the positive rate of anti-HBs peaked at 7-12 months after birth,accounting for 93%,then it decreased to 65.3% at 25-30 months after birth.The proportion of the neonates with positive anti-HBs was the highest among 0-1-month-old neonates,then it decreased with age.There was no statistically significant difference in the positive rates of antibodies between 0-1-month-old neonates and the mothers,the positive rate of anti-HBs in the neonates whose mothers were found with positive HBsAg was 100%.Conclusion:HBV markers should be detected at one month and 25 months after end of HBV vaccine inoculation to improve the detection rates of HBV immunization failure and attenuation of anti-HBs level,carry out secondary inoculation timely.For the infants whose mothers were carriers of HBV,examination of HBV markers should be performed at birth,one month and 25 months after immunization to detect the blocking effect for neonates and dynamic changes of HBV markers.