中小学生乙肝疫苗强化免疫后无应答影响因素分析

发布时间：2019-05-10 06:53

【摘要】：目的研究中小学生乙肝疫苗强化免疫后无应答的发生率及其影响因素,为乙肝免疫的合理接种与补种提供依据。方法对检测发现HBsAg和抗-HBs两项指标均为阴性的乌鲁木齐县469名中小学生进行0,1两针剂乙肝疫苗接种,采用酶联免疫法(ELISA)检测抗-HBs。根据检测结果分为抗-HBs无应答组(病例组)和应答组(对照组),并调查相关暴露因素,采用SPSS 17.0软件进行1∶2病例对照单因素和多因素条件Logistic回归分析。结果中小学生乙肝疫苗无应答率为11.94%。单因素分析发现,与无应答相关的因素为拔牙(OR=4.932,95%CI=1.091~22.295)、分娩地点(OR=0.361,95%CI=0.165~0.790)、新生儿出生体重(OR=0.255,95%CI=0.116~0.560)、喂养方式(OR=0.423,95%CI=0.179~0.999)、新生儿24 h内接种乙肝疫苗(OR=0.453,95%CI=0.209~0.980);多因素条件Logistic回归分析中,最终进入模型的因素有拔牙(OR=5.416,95%CI=1.197~24.506)、新生儿出生体重(OR=0.410,95%CI=0.172~0.979)、分娩地点(OR=0.445,95%CI=0.213~0.929)、新生儿24 h内接种疫苗(OR=0.399,95%CI=0.184~0.863)。结论中小学生乙肝疫苗无应答与多种因素有关,拔牙是无免疫应答的危险因素,而医院分娩、母乳喂养、新生儿24 h内接种乙肝疫苗则是保护因素。
[Abstract]:Objective to study the incidence and influencing factors of hepatitis B vaccine no response in primary and middle school students, and to provide evidence for reasonable vaccination and supplement of hepatitis B immunization. Methods 469 primary and middle school students in Urumqi County who were negative for HBsAg and anti-HBs were vaccinated against hepatitis B vaccine with two injections. Anti-HBs. was detected by enzyme-linked immunosorbent assay (ELISA). According to the test results, they were divided into anti-HBs non-response group (case group) and response group (control group). The related exposure factors were investigated. SPSS 17.0 software was used to analyze the single factor and multivariate conditional Logistic regression analysis of 1:2 case control. Results the non-response rate of hepatitis B vaccine in primary and middle school students was 11.94%. Univariate analysis showed that the factors associated with non-response were tooth extraction (OR=4.932,95%CI=1.091~22.295), place of delivery (OR=0.361,95%CI=0.165~0.790), neonatal birth weight (OR=0.255,95%CI=0.116~0.560), The newborn was vaccinated with hepatitis B vaccine (OR=0.453,95%CI=0.209~0.980) within 24 hours after feeding (OR=0.423,95%CI=0.179~0.999). In multivariate conditional Logistic regression analysis, the final factors entering the model were tooth extraction (OR=5.416,95%CI=1.197~24.506), neonatal birth weight (OR=0.410,95%CI=0.172~0.979), delivery site (OR=0.445,95%CI=0.213~0.929). The newborn was vaccinated within 24 hours (OR=0.399,95%CI=0.184~0.863). Conclusion the non-response of hepatitis B vaccine in primary and middle school students is related to many factors. Tooth extraction is the risk factor of no immune response, while hospital delivery, breastfeeding and hepatitis B vaccination within 24 hours are the protective factors.
【作者单位】：新疆医科大学公共卫生学院;复旦大学公共卫生学院流行病与统计教研室;喀什地区疾病预防控制中心;麦盖提县疾病预防控制中心;
【基金】：教育部科学技术研究重点项目(212195) 新疆维吾尔自治区自然科学基金—医学联合基金资助项目(2014211C009) 新疆自治区自然科学基金项目(201233146-11) 新疆自治区人才开发专项项目(2012-2)
【分类号】：R186

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