中文摘要：

目的探讨HBsAg阳性母亲所生婴儿乙型肝炎（乙肝）疫苗无／弱应答的影响因素。方法收集2011年7月至2013年1月在太原市第三人民医院妇产科分娩的HBsAg阳性母亲及其新生儿286对，按我国0-1-6月免疫接种程序对新生儿进行乙肝疫苗接种并随访至12月龄。检测母亲、新生儿及婴儿外周血HBV血清标志物及HBVDNA；探讨HBsAg阳性母亲所生婴儿乙肝疫苗无／弱应答的影响因素。结果286例婴儿中，乙肝疫苗无／弱应答率为18．53％（53／286）。非条件logistic回归显示，母亲HBVDNA≥1×10’copies／ml时其婴儿发生乙肝疫苗无弱应答的风险是HBVDNA阴性的2．592倍（OR=2．592，95％CI：1．121～5．996）；分娩方式为阴道产时其婴儿发生乙肝疫苗无／弱应答的风险是剖宫产的1．932倍（OR=1．932，95％CI：1．021～3．654）。二者既不存在相乘交互作用（OR=1．055，95％CI：0．209～5．321），也不存在相加交互作用（RERI=1．617，95％CI：-4．038～7．272；AP=-0．364，95％CI：-0．527～1．225；S／=1．195，95％CI：0．270～13．135）。将母亲HBVDNA分组后，剖宫产与阴道产对婴儿发生乙肝疫苗无／弱应答之间差异无统计学意义。结论HBsAg阳性母亲HBVDNA≥1×10^7copies／ml时，其婴儿易发生乙肝疫苗无／弱应答。

英文摘要：

Objective To investigate the influencing factors for non/low-response to hepatitis B vaccine in infants of HBsAg-positive mothers. Methods A total of 286 HBsAg-positive pregnant women and their infants were recruited from the Third People＇ s Hospital of Taiyuan during July 2011 to January 2013. The infants were immunized with hepatitis B vaccine according to the 0-1-6 month vaccination schedule and followed up for 12 months. The serum HBV DNA level of mothers, neonates and infants were detected by electro chemiluminescence immunoassay kits and fluorescene qnantiative polymerase chain rection. Results Among 286 infants, the rate of non/low-response to hepatitis B vaccine was 18.53% （53/286）. Non-conditional logistic regression analysis indicated that the mother＇ s HBV DNA level /〉 1 X 107 copies/ml （0R=2.592, 95%CI： 1.121-5.996） and natural birth （OR： 1.932, 95%CI： 1.021-3.654） were the risk factors for non/low-response to hepatitis B vaccine, the risks were 2.592 times and 1.932 times higher compared with the infants whose mothers were HBV DNA negative and the infants whose mothers had cesarean delivery. There was no multiplicative or additive interaction between high HBV DNA load and natural birth （OR： 1.055, 95%CI： 0.209-5.321 ）, （RERI= 1.617, 95% CI： -4.038-7.272; AP--0.364, 95% CI： -0.527-1.225; SI= 1.195, 95%CI： 0.270-13.135）.After stratified analysis of mother＇s HBV DNA level, delivery mode of mothers was not associated with non/low-response of their infants. Conclusion The mother＇ s load of HBV DNA≥1 × 10^7 copies/ml might be the factor for non/low-response to hepatitis B vaccine in infants of HBsAg positive mothers.