摘要
目的探究HBsAg阳性母亲婴儿乙肝疫苗应答反应的相关因素,为临床防治HBsAg阳性母亲婴儿乙肝疫苗无/弱应答反应提供相应的经验和依据。方法选取2014年2月至2016年2月期间在惠州市第六人民医院接受治疗的HBsAg阳性母亲及其婴儿106对作为研究对象。婴儿按照0-1-6月免疫接种方案进行接种,随访12个月,收集母亲分娩前的肘静脉血、婴儿在出生后24h的肘静脉血及随访12个月后的婴儿肘静脉血备检,并采用单因素及多因素Logistic回归分析HBsAg阳性母亲婴儿乙肝疫苗应答反应的相关因素。结果 106例患者中,患者的HBV DNA阳性率为46.23%(49/106);随访12个月后,婴儿发生乙肝疫苗无/弱应答率为17.92%(19/106);强应答率为82.08%(87/106)。母亲HBV DNA阳性、母亲高载量HBV DNA、分娩方式与HBsAg阳性母亲婴儿乙肝疫苗应答反应有显著相关性(χ~2值分别为4.588、15.550、4.195,均P<0.05),而母亲年龄、母亲HBeAg性质、母亲分娩史与HBsAg阳性母亲婴儿乙肝疫苗应答反应无显著相关性(χ~2值分别为0.096、3.608、0.072,均P>0.05)。HBsAg阳性母亲婴儿乙肝疫苗应答反应的多因素分析结果显示:经因素调整后,母亲HBV DNA阳性、母亲高载量HBV DNA是影响HBsAg阳性母亲婴儿乙肝疫苗应答反应的独立危险因素(OR值分别为2.356、2.189,均P<0.05)。结论母亲HBV DNA阳性、母亲高载量HBV DNA为影响HBsAg阳性母亲婴儿乙肝疫苗应答反应的独立危险因素,婴儿较易发生乙肝疫苗无/弱应答。
Objective To explore the relevant factors of hepatitis B vaccine response in infants of HBsAg-positive mothers and to provide the corresponding experience and basis for clinical prevention and treatment of no or poor response of hepatitis B vaccine in infants of HBsAg positive mothers. Methods A total of 106 HBsAg-positive mothers and their infants who received treatment from February 2014 to February 2016 were selected as subjects. Infants received vaccination according to the 0- 1- 6 month immunization program, followed up for 12 months. Maternal venous blood of elbow vein before delivery and 24h after delivery as well as infants＇ elbow vein blood after 12 months were collected, and univariate and multivariate Logistic regression analysis were conducted to analyze the related factors of hepatitis B vaccine response in infants of HBsAg-positive mothers. Results In 106 patients, the positive rate of HBV DNA was 46.23% （49/106）. The no or poor response rate of hepatitis B vaccine was 17.92% （19/106） after 12 months of follow-up. The strong response rate was 82.08% （87/106）. Mother HBV DNA positive, high loads HBV DNA and delivery way were remarkably correlated with hepatitis B vaccine response in infants of HBsAg-positive mothers （χ^2 value was 4.588, 15.550 and 4.195, respectively, all P〈0.05）, but maternal age, maternal HBeAg nature and delivery history were not correlated with hepatitis B vaccine response in infants of HBsAg-positive mothers （χ^2 value was 0.096, 3.608 and 0.072, respectively, all P〉0.05）. Multivariate analysis revealed that maternal HBV DNA positive and high loads HBV DNA were the independent risk factors of hepatitis B vaccine response in infants of HBsAg-positive mothers after adjusting factors （OR value was 2.356 and 2. 189, respectively, both P 〈 0. 05 ）. Conclusion Maternal HBV DNA positive and high loads HBV DNA are the independent factors that affect the response of hepatitis B vaccine in infants of HBsAg-positive mothers, and the baby is prone to have
作者
杨锋
陈雅琴
林秋兰
庄家用
YANG Feng, CHEN Ya-qin, LIN Qiu-lan,ZHUANG Jia-yong(Department of Pediatric, The Sixth People＇s Hospital of Huizhou City, Guangdong Huizhou 516211, China)
出处
《中国妇幼健康研究》
2018年第3期379-381,共3页
Chinese Journal of Woman and Child Health Research
基金
惠州市科技计划资助项目(编号:170509221740598)
