| 摘要註: |
本論文之研究目的：台灣自1986年新生兒全面施打B肝疫苗，兒童B型肝炎帶原盛行率由實施前的10%逐年降到1%以下。然近年在本校大學新生體檢發現B型肝炎表面抗體(anti-HBs)陰性比率高達53%以上，故本研究進一步探討性別等因素與B型肝炎表面抗原(HbSAg)及anti-HBs之關係，並分析補接種一劑B肝疫苗後之成效。研究方法：收集2006至2012年南部某大學26108位新生體檢資料，分析1986年7月以後出生共21130位之本國籍大學生其HbSAg、anti-HBs之情形，及anti-HBs陰性者補接種一劑B肝疫苗後其成效，並探討與性別、年齡、疫苗世代等之相關。結果：收案21130人(男性11904人，女性9226人)，HbSAg陽性518人，19歲382人(2.3%)，20歲83人(3.0%)，21歲33人(2.7%)，22歲20人(3.8%)，統計上有顯著相關(p<0.05)。anti-HBs陽性9369人，男性5069人(42.6%)，女性4300人(46.6%)，統計上有顯著相關(p<0.05)，女性高於男性。血漿型疫苗世代7359人(45.9%)，基因工程型疫苗世代2010人(39.6%)，p<0.05。201人補接種一劑B肝疫苗後，anti-HBs陽性158人，血漿型疫苗世代104人(71.7%)，基因工程型疫苗世代54人(96.4%)，p<0.05。結論：HbSAg陽性率隨著年齡越大有增加趨勢。anti-HBs陽性率女性高於男性，注射血漿型疫苗世代比基因工程型疫苗世代中anti-HBs陽性率較高；但補接種一劑B肝疫苗後喚起免疫記憶則以基因工程型疫苗世代較佳，即其產生較好追加效果。故大學新生B型肝炎體檢有其必要性，且應積極予以anti-HBs陰性者補接種疫苗，有效提高anti-HBs濃度，增加保護力以防B型肝炎之感染。 Since 1986, the newborns in Taiwan received hepatitis B vaccination, and the prevalence ofhepatitis Bcarriers dropped from 10% to below 1%. In recent years, however, the rate of negative anti-HBs was found over 53% at freshmen’s examination. This search investigates the relation among gender, HBsAg and anti-HBs, and analyzes the effectiveness of hepatitis B vaccination after adding one dose of vaccine. Research Methods: Collecting the physical examination data of 26,108 freshmen in a certain university at southern Taiwan from 2006 to 2012, and analyzes the HBSAg and anti-HBs condition of 21,130 native university students who were born after July, 1986. We follow up the effectiveness of hepatitis B vaccination after adding one dose of vaccine and also investigate the relation among gender, age and the generation of the vaccine.Results: The collected cases are 21,130(male 11,904, female 9226). The total of positive HBsAg is 518. 382 are 19 years old(2.3%), 83 are 20 years old( 3.0%), 33 are 21years old(2.7%), 20 are 22 years old( 3.0%). According to the data above, it shows significant correlation (p<0.05).The total of positive anti-HBs is 9,369. 5,069 are male(42.6%), and 4,300 are female(46.6%). According to the data above, it shows significant correlation (p<0.05), and at the rate of positive anti-HBs female are higher than male. The number of students who received plasma generation vaccine at their childhood is 7,359(45.9%), and it is 2,010(39.6%) at those received recombinant vaccine at their childhood, p<0.05. 201 students received adding one dose of vaccine. 158 students showed positive post-booster anti-HBs. 104(71.7%) are plasma generation vaccine group, and 54(96.4%) are recombinant vaccine group, p<0.05.Conclusion:The HBsAg positive rate increased with age. The female’s anti-HBs positive rate is higher than male’s, and the positive rate of post-booster anti-HBs to is higher in recombinant vaccine group than in plasma generation vaccine group; the effect to evoke immune memory after adding one dose of hepatitis B vaccine, recombinant vaccine group is better. It is necessary for freshmen to examine hepatitis B. Booster hepatitis B vaccine for those both negative at HbsAg and anti-HBs is important to improve effectively the anti-HBs concentration and keep away from hepatitis B infection. |