甲肝减毒活疫苗及加服牛磺酸在接种乙肝疫苗免疫失败儿童中的致免疫性

目的为了估价甲肝减毒活疫苗在接种乙肝疫苗免疫失败儿童中的致免疫性和牛磺酸对该疫苗免疫性的影响。方法应用随机对照临床试验。选择９０名健康儿童随机分成二组：４３名接种甲肝减毒活疫苗和口服牛磺酸（Ⅰ组）；４７名接种疫苗加口服安慰剂（Ⅱ组）。另选择６２名由携带ＨＢＶ的无症状母亲所生接种过乙肝疫苗但是免疫失败者（Ⅲ组）和４４名同龄由ＨＢｓＡｇ阴性母亲所生接种乙肝疫苗正常免疫反应的健康儿童（Ⅳ组），均接种甲肝减毒活疫苗作比较。所有对象均除外甲肝感染，接种后观察反应，２个月后检测血清－ＨＡＶＩｇＧ抗体。结果Ⅰ组抗ＨＡＶＩｇＧ平均值显著高于Ⅱ组（ｔ＝７．１０９，Ｐ＜０．０１）；Ⅳ组接种甲肝疫苗后抗－ＨＡＶＩｇＧ平均值与Ⅲ组比较，差异有显著性，（ｔ＝１．９９８，Ｐ＜０．０５）。结论接种乙肝疫苗免疫失败儿童接种甲肝减毒活疫苗的免疫效果比健康儿童差。甲肝减毒活疫苗接种后随访未发现明显副反应。牛磺酸对疫苗接种效果的辅助作用值得推广应用。

Immunogenicity of attenuated hepatitis A virus (HAV) vaccine and combined oral Taurine in the children failed to respond to hepatitis B virus (HBV) vaccine

Objective To assess the immunogenicity of the live attenuated hepatitis A virus (HAV) vaccine in the children who failed to respond to hepatitis B virus (HBV) vaccine and evaluate the adjuvanticity of Taurine on the immunogenicity of HAV vaccine. Methods Ninety normal children were randomly divided into two groups. Among them, 43 children received the live attenuated HAV vaccine plus oral Taurine and 47 children received the vaccine plus oral placebo; 62 children who were born to HBV carriers and failed to respond to HBV vaccine and 44 children born to HBsAg negative mothers with normal response to HBV vaccine received the live attenuated HAV vaccine. Blood samples were taken on the day of the vaccine injection and 2 months later. Anti HAV IgG was detected by enzyme immuonassay. Results A significant difference was seen in anti HAV IgG response between (HAV) vaccine plus Taurine group and placebo at follow up period ( t =7.109, P <0.01). A significant defference was found in the absorbance value of anti HAV IgG between the children who were born to HBV carriers and failed to respond to HBV vaccine and the normal children born to HBsAg negative mothers and received the live attenuated HAV vaccine ( t =1.998, P <0.05). Conclusion Anti HAV IgG response of the children who failed to respond to HBV vaccine after injected with the live attenuated HAV vaccine was lower than that of normal children. No obvious side effects were noticed after the live attenuated HAV vaccine was used. The adjuvanticity of Taurine on the immunogenicity of live attenuated HAV vaccine was worthy to be further studied.