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[目的]通过评价新生儿血源性乙肝疫苗免疫后的远期保护效果,为进一步完善乙肝免疫预防策略提供依据。[方法]采用三层抽样方法,从上海市2个区1986—1996年出生的有全程血源性乙肝疫苗接种史的人群中抽取2692人作为调查对象,按免疫后不同时间分11个组,进行问卷调查,并采集静脉血进行乙肝表面抗体(anti-HBs)定量、乙肝表面抗原(HBsAg)与乙肝核心抗体(anti-HBc)检测。[结果]HBsAg阳性率平均为1.75%,未见随年龄增加而上升的趋势。anti-HBc阳性率平均为3.64%,呈随年龄增长而上升趋势。anti-HBs阳性率平均为40.16%;18岁以下青少年anti-HBs阳性率随年龄增长而下降,19岁以上者anti-HBs阳性率随年龄增长而上升。15～19岁组人群anti-HBs阴性率最高(66.80%)。多因素分析显示母亲孕期乙肝e抗原(HBeAg)阳性、家庭成员HBsAg阳性、男性、年龄增大是青少年感染乙肝的危险因素。[结论]血源性乙肝疫苗具有较持久的保护效果。建议开展15岁以上人群的定期随访,对anti-HBs阴性者需加强免疫。
[Objective] To evaluate the long-term protection effect of newborn blood-borne hepatitis B vaccine and provide evidence for further improvement of hepatitis B immune prevention strategy. [Method] With the method of three-layer sampling, 2692 people were selected from the population with full history of blood-borne hepatitis B vaccination born in two districts of Shanghai from 1986 to 1996. The subjects were divided into 11 groups at different time points after immunization, A questionnaire survey was conducted. Venous blood was collected for quantification of anti-HBs, detection of HBsAg and anti-HBc. [Results] The average positive rate of HBsAg was 1.75%, but no increase with age. The average positive rate of anti-HBc was 3.64%, showing an upward trend with age. The average positive rate of anti-HBs was 40.16%. The positive rate of anti-HBs in adolescents under 18 years old decreased with the increase of age. The positive rate of anti-HBs in patients over 19 years old increased with age. The anti-HBs negative rate was the highest in the age group of 15-19 years (66.80%). Multivariate analysis showed that the mother was positive for hepatitis B e antigen (HBeAg) during pregnancy and HBsAg was positive for family members. The male and the aged were the risk factors of adolescent hepatitis B infection. [Conclusion] The blood-borne hepatitis B vaccine has long-lasting protective effect. It is recommended to carry out regular follow-up of people over the age of 15, anti-HBs negative need to strengthen the immune.