摘要:
Objective To investigate the impact of maternal serum anti-hepatitis B surface antibody(anti-HBs) on their newborn response to hepatitis B vaccination. Method 60 pregnant women (31 with serum anti-HBs positive and 29 negative)and their single newborns were recruited between June 2012 and June 2013 in this study,and the fetuses were vaccinated with hepatitis B vaccine instance,1 month and 6 months after birth. All the fetuses were followed-up for three years. Results At the end of one year followed-up,the nonresponse,lower response,normal response and strong response rates in children with their mother's serum anti-HBs positive were 12.9%,22.6%,29.0% and 35.5%,without significant differences as compared to 10.3%,20.7%,37.9% and 31.0%(P>0.05)in children with their mother's serum anti-HBs negative;at the end of 3 year followed-up,serum anti-HBs positive in children with their mother's serum anti-HBs positive were 87.1%,no significant difference as compared to 89.7% (P>0.05)in children with their mother's serum anti-HBs negative;serum anti-HBs levels represented by geometric average concentration (GMC)in children with their mother's serum anti-HBs positive and negative were 74.3 (6.3~854.0)mIU/ml and 73.6 mIU/ml (3.4~950.6)mIU/ml,respectively,no significant difference (P>0.05),while they both decreased as compared to serum levels of their own at the end of one year [1162.1 (164.5~3202.3)mIU/ml and 1104.2 mIU/ml (153.0~2584.7) mIU/ml,respectively,P0.05);3年后,母亲血清抗-HBs阳性组幼儿血清抗-HBs阳性率为87.1%,与血清抗-HBs阴性组的89.7%比,无显著性差异(P>0.05);母亲血清抗-HBs阳性组与阴性组幼儿血清抗-HBs水平分别为74.3(6.3~854.0)mIU/ml和73.6(3.4~950.6)mIU/ml,两组差异无统计学意义(P>0.05),但均明显低于1年时各自的水平[分别为1162.1 (164.5~3202.3)mIU/ml和1104.2(153.0~2584.7)mIU/ml,P<0.05];在3岁末,60名幼儿血清HBsAg和抗-HBc均为阴性,对7名血清抗-HBs阴性儿童加强接种后,结果6个月后,6名幼儿血清抗-HBs转阳.结论 按照目前国家推荐的接种计划对新生儿接种乙肝疫苗能够有效地保护其对抗HBV感染,母亲血清抗-HBs阳性可能并不会对新生儿接种乙肝疫苗的免疫应答产生不良影响.