不同乙肝疫苗接种方案在入伍新兵中的免疫效果观察
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摘要
目的观察不同接种方案乙肝疫苗在入伍新兵中的免疫效果,探索更适合军队的接种方案。方法采用整群抽样方法,纳入某军队院校2017年9月338名入伍新兵,根据不同接种方案分为4组。传统组(n=71):分别在0、1、6个月接种疫苗20μg;加速组(n=99):分别在0、1、2个月接种疫苗20μg;传统加强组(n=77):分别在0、1、6个月接种疫苗40μg;加速加强组(n=91):分别在0、1、2个月接种疫苗40μg。比较4种方案的抗-HBs阳转率、时效性和安全性。结果 4组抗-HBs阳转率分别为90.14%、90.91%、98.70%和98.90%。在接种剂量相同的情况下,0、1、2个月方案与传统0、1、6个月方案的抗-HBs阳转率差异无统计学意义(P>0.05),但接种周期大大缩短;在接种时间相同的情况下,每次接种40μg较20μg的抗-HBs阳转率明显升高(P=0.03)。4组间不良反应发生率的差异无统计学意义(P=0.97)。结论适当增加接种剂量可显著提高乙肝接种成功率,且安全性良好。乙肝加速加强接种法接种成功率高,接种周期缩短,适宜在新兵中推广应用。
Objective To observe the immune effect of different hepatitis B vaccine(vaccine) programs on the military new soldiers for exploring more suitable hepatitis B vaccine vaccination programs according to the the army 's actual situation. Methods On the basis of a cluster random sampling, 338 military new soldiers in military college as research object in September 2017 were divided into four groups according to the inclusion criteria and different vaccination programs: Traditional group(n=71), 20μg vaccine was given at 0, 1 and 6 months, respectively; Acceleration group(n=99), the same dose of vaccine was given at 0, 1 and 2 months, respectively; Traditional reinforcement group(n=71), the vaccine was given at 0, 1 and 6 months, respectively; Accelerated reinforcement group(n=77), 40μg vaccine was given at 0, 1 and 2 months, respectively. The success rate, timeliness and safety were compared between the four programs. Results The success rates of the four groups were 90.14%, 90.91%, 98.70% and 98.90% respectively. Under the same dose, the success rate at 0, 1 and 2 month programs was not different from that of traditional 0, 1 and 6 month programs(P>0.05), but the vaccination cycle was greatly shortened; Under the same time points, the success rate of 40μg was significantly higher than that of 20μg(P=0.03). There was no statistically significant difference in the incidence rate of adverse reactions between the four groups(P=0.97). Conclusions Appropriate increase of dose can significantly improve the success rate and greatly shorten the vaccination cycle with a good security. Accelerated and intensive vaccination program is suitable for wider use among military new soldiers.
Objective To observe the immune effect of different hepatitis B vaccine(vaccine) programs on the military new soldiers for exploring more suitable hepatitis B vaccine vaccination programs according to the the army 's actual situation. Methods On the basis of a cluster random sampling, 338 military new soldiers in military college as research object in September 2017 were divided into four groups according to the inclusion criteria and different vaccination programs: Traditional group(n=71), 20μg vaccine was given at 0, 1 and 6 months, respectively; Acceleration group(n=99), the same dose of vaccine was given at 0, 1 and 2 months, respectively; Traditional reinforcement group(n=71), the vaccine was given at 0, 1 and 6 months, respectively; Accelerated reinforcement group(n=77), 40μg vaccine was given at 0, 1 and 2 months, respectively. The success rate, timeliness and safety were compared between the four programs. Results The success rates of the four groups were 90.14%, 90.91%, 98.70% and 98.90% respectively. Under the same dose, the success rate at 0, 1 and 2 month programs was not different from that of traditional 0, 1 and 6 month programs(P>0.05), but the vaccination cycle was greatly shortened; Under the same time points, the success rate of 40μg was significantly higher than that of 20μg(P=0.03). There was no statistically significant difference in the incidence rate of adverse reactions between the four groups(P=0.97). Conclusions Appropriate increase of dose can significantly improve the success rate and greatly shorten the vaccination cycle with a good security. Accelerated and intensive vaccination program is suitable for wider use among military new soldiers.
引文
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[14]Zhou CY.The immune effect of different doses hepatitis Bvaccine of domestic on adult[J].Jian J Preb Med,2015,26(5):63-64.[周艳春.国产乙肝疫苗不同接种剂量对成人免疫效果[J].江苏预防医学,2015,26(5):63-64.]
[15]Wang XW,Zhong YX,Yao XR,et al.Observation the immune effect of increase different doses in patients with no(low)response in hepatitis B vaccine[J].North Drug,2015,12(1):80-81.[王晓炜,钟运香,姚雪榕,等.乙肝疫苗无(低)应答者加大不同剂量再免疫效果观察[J].北方药学,2015,12(1):80-81].
[2]Wang SL,He GS,Shen WY,et al.Reactivation of hepatitis B virus infection in aplastic anemia patients treated by immunosuppressive therapy[J].Chin J Pract Intern Med,2017,37(5):460-464.[王素丽,何广胜,沈文怡,等.再生障碍性贫血合并乙型肝炎病毒感染60例免疫抑制治疗疗效分析[J].中国实用内科杂志,2017,37(5):460-464.]
[3]Chen SY,Wang XC,Dong XL,et al.Effects of two immunization schedules of Recombinant yeast-derived hepatitis vaccine for adults[J].Chin Prev Med,2013,14(02):96-98.
[4]Ganem D,Prince AM.Hepatitis B virus infection-natural history and clinical consequences[J].N Engl J Med,2004,350(11):1118-1129.
[5]Yang HY,Sun AM,Cheng HW,et al.Randomized,doubleblind,parallel clinical trial of entecavir capsules in treating patients with chronic hepatitis B[J].J Zhengzhou Univ(Med Sci),2017,52(5):633-637.[杨荟玉,孙爱民,程豪为,等.国产恩替卡韦胶囊治疗慢性乙型肝炎的随机、双盲、阳性药物平行对照临床研究[J].郑州大学学报(医学版),2017,52(5):633-637.]
[6]Gao DQ,Qiao Y,Zhao JP,et al.Investigation on cases of hepatitis b in an army and analysis of risk factors for infection[J].Prev Med Chin PLA,2016,34(6):795-798.[高东旗,乔杨,赵景平,等.某部乙型病毒性肝炎病例调查及感染危险因素[J].解放军预防医学杂志,2016,34(6):795-798.]
[7]Cao WM,Tang Y,Chang GH,et al.The immunity effect of hepatitis b vaccine in the military population[J].Prev Med Chin PLA,2016,34(3):327-330.[曹玮民,唐玥,常国辉,等.重组乙肝疫苗在部队人群中免疫效果观察[J].解放军预防医学杂志,2016,34(3):327-330.]
[8]Feng LJ,Niu YJ,Jia JD,et al.Advances in hepatitis B vaccination after liver transplantation for hepatitis B related liver diseases[J].Natl Med J China,2012,92(7):499-501.[冯丽娟,牛玉坚,贾继东,等.乙肝相关性肝病肝移植术后乙肝疫苗接种研究进展[J].中华医学杂志,2012,92(7):499-501.]
[9]Feng L,Niu Y,Chen H,et al.Immunogenicity of different hepatitis B virus vaccination schedules in liver transplant recipients[J].Hepatol Res,2013,43(5):495-501.
[10]Wang WW,Wang L,Zhu XW,et al.Impact of different hepatitis B vaccine immunization schedules on immune seroconversion and Th2 cell changes among liver transplantation recipients[J].Chin J Vacc Immu,2017,23(2):144-147.[王维伟,王麟,朱雄伟,等.乙肝疫苗不同接种方案对肝移植受者接种成功率及Th2细胞变化的影响[J].中国疫苗与免疫,2017,23(2):144-147.]
[11]Xi YJ.Comparing immunization procedures and nursing intervention of three different doses of hepatitis B vaccine[J].Nurse Pract Res,2016,13(9):152-153.[席艳君.3种不同剂量乙肝疫苗的免疫程序比较及护理干预[J].护理实践与研究,2016,13(9):152-153.]
[12]Sha HY.Analysis of epidemic characteristics and epidemic prediction of hepatitis b in military in 2012-2016[D].Academy of Military Medical Sciences of PLA,2017.[沙花燕.2012-2016年军队乙型肝炎流行特征分析及疫情预测研究[D].中国人民解放军军事医学科学院,2017.]
[13]Cao Y.Analysis of the immune response in adults vaccinated with 20 micrograms of recombinant hepatitis B[J].J Path Bio,2016,11(5):444-447.[曹跃.成人接种20μg重组乙肝疫苗免疫应答效果分析[J].中国病原生物学杂志,2016,11(5):444-447.]
[14]Zhou CY.The immune effect of different doses hepatitis Bvaccine of domestic on adult[J].Jian J Preb Med,2015,26(5):63-64.[周艳春.国产乙肝疫苗不同接种剂量对成人免疫效果[J].江苏预防医学,2015,26(5):63-64.]
[15]Wang XW,Zhong YX,Yao XR,et al.Observation the immune effect of increase different doses in patients with no(low)response in hepatitis B vaccine[J].North Drug,2015,12(1):80-81.[王晓炜,钟运香,姚雪榕,等.乙肝疫苗无(低)应答者加大不同剂量再免疫效果观察[J].北方药学,2015,12(1):80-81].