中国疫苗和免疫2024，Vol.30Issue(4) ：383-388.DOI:10.19914/j.CJVI.2024062

≥18岁维持性血液透析患者乙型肝炎疫苗不同免疫程序无或弱应答的影响因素及其交互作用

Factors influencing immune response to different immunization schedules with hepatitis B vaccine in adult hemodialysis patients,and interactions between factors

刘黎明 屈晓群 门朝月 姚添 常越 王建民 王富珍 王素萍 闫三华 冯永亮
中国疫苗和免疫2024，Vol.30Issue(4) ：383-388.DOI:10.19914/j.CJVI.2024062
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≥18岁维持性血液透析患者乙型肝炎疫苗不同免疫程序无或弱应答的影响因素及其交互作用

Factors influencing immune response to different immunization schedules with hepatitis B vaccine in adult hemodialysis patients,and interactions between factors

刘黎明 1屈晓群 1门朝月 2姚添 3常越 4王建民 1王富珍 5王素萍 2闫三华 1冯永亮2
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作者信息

  • 1. 临汾市中心医院肾病内科,山西临汾 041000
  • 2. 山西医科大学公共卫生学院流行病学教研室,山西太原 030001;山西医科大学临床流行病学与循证医学中心,山西太原 030001;山西医科大学煤炭环境致病与防治教育部重点实验室,山西太原 030001
  • 3. 山西医科大学临床流行病学与循证医学中心,山西太原 030001;山西医科大学第一临床医学院,山西太原 030001
  • 4. 山西医科大学公共卫生学院流行病学教研室,山西太原 030001
  • 5. 中国疾病预防控制中心免疫规划中心,北京 100050
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摘要

目的 探讨维持性血液透析(Maintenance hemodialysis,MHD)患者乙型肝炎(乙肝)疫苗(Hepatitis B vaccine,HepB)不同免疫程序无/弱应答的影响因素及其交互作用.方法 在山西省11所医院招募≥18岁MHD患者,随机分为0-1-6月20 µg、0-1-2-6月20 µg和0-1-2-6月60 μg HepB免疫程序组,检测接种后1个月血清乙肝表面抗体(Hepatitis B surface antibody,HBsAb),分析无/弱应答(HBsAb＜100 mIU/mL)的影响因素及其交互作用.结果 MHD患者全程接种HepB后HBsAb无/弱应答率为25.55％(116/454).多因素Logistic回归分析显示,与0-1-6月20 μg程序相比,0-1-2-6 月 60 μg 和 20 μg程序的无/弱应答率低(OR=0.44,95％CI:0.26-0.75;OR=0.52,95％CI:0.31-0.88);≥50岁、有糖尿病者的无/弱应答率分别较＜50岁、无糖尿病者高(0R=2.02,95％CI:1.29-3.18;OR=1.91,95％CI:1.16-3.12).免疫程序与年龄之间存在相乘交互作用(0R=1.91,95％CI:1.16-3.14).结论 采用常规免疫程序、高年龄和有糖尿病的MHD患者易发生HepB接种后无/弱应答,免疫程序与年龄之间存在交互作用.

Abstract

Objective To explore factors influencing immune response to different immunization schedules with hepatitis B vaccine(HepB)in maintenance hemodialysis(MHD)patients and interactions between factors.Methods We recruited MHD patients aged ≥18 years from 11 hospitals in Shanxi province and randomized consenting patients to receive either a 0-1-6-month 20 µg,a 0-1-2-6-month 20 µg,or a 0-1-2-6-month 60 μg HepB immunization schedule.We tested sera for hepatitis B surface antibody(HBsAb)obtained one month after the last dose of the assigned HepB series schedule to determine factors influencing non-/hypo-response(HBsAb＜100 mIU/mL)and interactions among factors.Results The overall non-/hypo-response rate was 25.55％(116/454)among MHD patients after full-series HepB vaccination.Multivariate logistic regression analysis showed that the non-/hypo-response rate was lower among subjects who received a 0-1-2-6-month 60 µg or a 0-1-2-6-month 20 µg schedule than among subjectswho received a 0-1-6-month 20 μg schedule(OR=0.44,95％CI:0.26-0.75;OR=0.52,95％CI:0.31-0.88);and was higher among subjects ≥50 years of age and subjects with diabetes compared with subjects＜50 years of age and subjects without diabetes(OR=2.02,95％CI:1.29-3.18;OR=1.91,95％CI:1.16-3.12),respectively.There was a multiplicative interaction between immunization schedule and age(OR=1.91,95％CI:1.16-3.14).Conclusions MHD patients who received a routine 0-1-6-month 20 μg HepB immunization schedule,who were older,and who had diabetes were prone to non-/hypo-response to HepB vaccination.There was an interaction between age and immunization schedule.

关键词

维持性血液透析/乙型肝炎疫苗/预防接种/无/弱应答/影响因素/交互作用

Key words

Maintenance hemodialysis/Hepatitis B vaccine/Vaccination/Non-/hypo-response/Influencing factor/Interaction

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基金项目

国家科技重大专项(2018ZX10721-202)

出版年

2024
中国疫苗和免疫
中国疾病预防控制中心

中国疫苗和免疫

CSTPCDCSCD北大核心
影响因子：2.311
ISSN：1006-916X
参考文献量28
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