健康人群乙型肝炎疫苗再免疫抗体应答

目的探讨不同年龄组健康人群接种不同类型、不同剂量乙型肝炎（乙肝）疫苗（Hepatitis B Vaccine,HepB）的再免疫抗体应答。方法采用分层随机抽样方法,按地域分布选取东莞市5个镇2～4、6～8、13～15、16～40岁4个年龄组健康人群,用酶联免疫吸附试验筛查乙肝病毒核心抗体、乙肝病毒表面抗原和乙肝病毒表面抗体均为阴性,且有3剂HepB免疫史的人作为再免疫研究对象。采用5μg重组HepB（酵母）（HepB Made by Recombinant DNA Techniques in Yeast,HepB-Y）、10μg HepB-Y、10μg重组HepB（中国仓鼠卵巢细胞）（HepB Made by Recombinant DNA Techniques in CHO Cell,HepB-CHO）、10μg重组HepB（汉逊酵母）（HepB Made by Recombinant DNA Techniques in Hansenula Yeast,HepB-HY）、20μg HepB-CHO和20μg HepB-Y,均按0、1、6个月程序再免疫3剂。结果不同类型不同剂量HepB在人群中的再免疫成功率和抗体水平中位数[毫国际单位/毫升（mIU/ml）]分别为：5μg HepB-Y94.34%和226.53,10μg HepB-Y86.46%和175.36,10μg HepB-CHO97.39%和331.44,10μg HepB-HY91.30%和439.01,20μg HepB-CHO99.20%和386.66,20μg HepB-Y89.04%和372.97。各年龄组的再免疫成功率和抗体水平中位数（mIU/ml）分别是：2～4岁98.25%和353.42,6～8岁96.80%和320.31,13～15岁94.67%和282.12,16～40岁87.76%和305.24。结论年龄、疫苗种类和剂量是影响再免疫抗体应答的主要因素,随年龄的增长再免疫抗体应答下降,更换疫苗种类可提高再免疫抗体应答。

Immunoreaction Levels of Revaccination in Healthy Population with Hepatitis B Vaccine

Objective To observe and compare the immunoreaction levels of revaccination with different hepatitis B vaccine in healthy population of different age groups. Methods Multi-stage random sampling method was used, 2 to 4 years old, 6 to 8 years old, 13 to 15 years old and 16 to 40 years old healthy people had been sampled in five towns according to different district. Screened those people＇s HBV serologic markers by ELISA, the person whose HBV serologic markers were all negative and had been vaccinated three doses of hepatitis B vaccine would be the revaccination recipients. Six kinds of recombinant Hepatitis B vaccine （yeast-derived or CHO cells） with 5μg, 10μg and 20μg were used for the recipients on a 0-1-6 month schedule. Results Successful rates of revaccination and the median of antibody levels （mIU/ml） in the recipients were 94.34% and 226.53 in 5μg yeast-derived vaccine group, 86.46% and 175.36 in 10μg yeast-derived vaccine group, 97.39% and 331.44 in 10μg CHO cells vaccine group, 91.30% and 439.01 in 10μg Hansenula yeast-derived vaccine group, 99.20% and 386.66 in 20μg CHO cells vaccine group, 89.04% and 372.97 in 20μg yeast-derived vaccine group, 98.25% and 353.42 in2 to 4 years old group, 96.80% and 320.31 in 6 to 8 years old group, 94.67% and 262.12 in 13 to 15 years old group, 87.76% and 305.24 in 16 to 40 years old group. Conclusion Age, vaccine and dose were the most important factors to affect the immunoreaction levels of revaccination. There was an age-specific decline in immunogenicity, the immunoreaction levels of revaccination will be improved by changing vaccine.