摘要
目的探讨成年人乙型肝炎（简称乙肝）疫苗接种后无或弱免疫应答者三种不同方案再免疫的效果。方法采用随机（数字表法）、开放性的研究方法，对2年内至少完成1个标准乙肝疫苗免疫接种程序、复查乙肝病毒标志物均阴性者，随机（数字表法）地接受3种再免疫方案，A组：34例，先予粒细胞-巨噬细胞集落刺激因子（GM．CSF）300μg皮下注射，次日开始按常规程序予乙肝疫苗接种，10μg/次；B组：33例，单纯乙肝疫苗接种，20μg／次；C组：33例，单纯乙肝疫苗复种，10μg／次。接种首针前及首针后第1、2、8个月（T1、T2、T8）检测乙肝病毒表面抗体（抗-HBs）。结果T1时，联合GM—CSF组、20μg组和10μg组抗-HBs阳性率分别为26．47％，48．48％和18．18％（X2=7．20，P=0．027）；T8时，20μg组抗一HBs阳性率达75．76％，联合GM—CSF组达64．71％，均高于10μg组的39．39％（x。=9．07，P=0．011）。20μg组在T1时抗-HBs滴度（417．00-4-69．36）高于联合GM—CSF组（203．74±79．56），在他时抗一HBs滴度（458．17±64．09）高于复种组（257．86±76．60），T8时20μg组（532．73±68．82）和联合GM—CSF组（501．48±70．00）抗-HBs滴度均高于10μg组（256．12±75．39）（t=4．27，P=0．0173）。结论对乙肝疫苗无（弱）应答者增加疫苗剂量和联合GM—CSF方案进行加强免疫是有效的措施，免疫效果均优于单纯复种。
Objective To investigate the immune effects of three different programs for revaccination among adults of non- and hypo-responders to recombinant Hepatitis B vaccine. Methods Those who were once immunized with recombinant Hepatitis B vaccine more than one standard schedule （0, 1 ,and 6 months） in two years and negative for Hepatitis B markers were randomly given three,different projects for revaccination. 34 adults of A group were given GM-CSF 300 μg by subcutaneous injection for the first day ,then 10μg each time by intramuscular route for routine immune method. 33 adults of B group were given Hepatitis B vaccine 20 μg each time. 33 adults of C group were given Hepatitis B vaccine 10 p±g each time. The blood samples were collected before the first injection and in 1,2 and 8 months following the first injection to test Anti-HBs. Results At T1, the anti-HBs positive conversion rate of group A, B and C was 26.47%, 48.48% and 18. 18% respectively （x2 = 7.20, P = 0. 027 ） . At TS, the anti-HBs positive conversion rate of group A （ 64. 71% ） and group B （ 75.76% ） were higher than group C （ 39. 39% ）, and there was significant difference （ x2 = 9.07, P = 0.011 ）. At T1, the anti-HBs level of group B （417.00 ± 69. 36） was higher than that of group A（203.74 ＋79.56）. At T2,the anti-HBs level of group B（458. 17 ±64. 09） was higher than that of group C（257. 86 ±76. 60）. At T8 ,the anti-HBs level of group A（501.48 ± 70.00） and group B （532.73 ±68.82）were higher than those of group C（256. 12 ±75.39） （t =4. 27 ,P = 0. 0173）. Conclusion Schemes of augmentation doses of Hepatitis B vaccine and being combined with GM-CSF should be in effect for non- and hypo-responders to Hepatitis B vaccine.
出处
《中华预防医学杂志》
CAS
CSCD
北大核心
2009年第1期37-40,共4页
Chinese Journal of Preventive Medicine
基金
基金项目：广东省科学技术委员会科技计划项目（20088030301048）
国家质检总局广东出入境检验检疫局科技计划项目资助（2005GDK44）
关键词
成年人
肝炎疫苗
乙型
肝炎抗体
乙型
抗体生成
粒细胞巨噬细胞集落
刺激因子
Adult
Hepatitis B vaccines
Hepatitis B antibodies
Antibody formation
Granulocyte-macrophage colony-stimulating factor
