Marangi A L, Giordano R, Montanaro A, De Padova F, Schiavone M G, Fedele A R, Basile C
Nephrology Unit, Hospital of Martina Franca, Italy.
Nephron. 1992;61(3):331-2. doi: 10.1159/000186928.
A prospective study was performed in 40 chronic uremics which included: (1) the intramuscular administration to all patients of 40 micrograms of a DNA-recombinant vaccine (Engerix-B) at 0, 1, 2, 6 months; (2) an intramuscular booster dose of 40 micrograms at 18 months in patients having an anti-HBs titer greater than 100 mIU/ml at the 7th month (group A); (3) a further intramuscular supplementary dose of 40 micrograms at 12 months (besides that at 18 months) in patients developing an antibody titer less than 100 mIU/ml at the 7th months (group B); (4) an intradermal course of 5 micrograms of vaccine every 2 weeks until the protective titer (greater than or equal to 10 mIU/ml) was achieved, and then every month for a total of 6 months in patients who did not develop a protective titer even after 19 months (group C). At the end of the study, all patients had developed a protective titer: 77.5% after the 4th intramuscular dose, 12.5% after the 5th and 10% after 3.5 +/- 0.5 (mean +/- SEM) intradermal inoculations. The mean antibody titers were 1,461 +/- 98 mIU/ml in group A, 594 +/- 684 in group B and 131 +/- 133 in group C. In conclusion, our two-step integrated protocol gives an anti-HBs protective titer in all our patients.
对40例慢性尿毒症患者进行了一项前瞻性研究，包括：(1) 在0、1、2、6个月时给所有患者肌肉注射40微克重组DNA疫苗（安在时-B）；(2) 对于在第7个月时抗-HBs滴度大于100 mIU/ml的患者，在18个月时肌肉注射40微克加强剂量（A组）；(3) 对于在第7个月时抗体滴度小于100 mIU/ml的患者，在12个月时（除18个月时的剂量外）再肌肉注射40微克补充剂量（B组）；(4) 对于即使在19个月后仍未产生保护性滴度的患者，每2周进行一次5微克疫苗的皮内接种，直至达到保护性滴度（大于或等于10 mIU/ml），然后每月接种一次，共6个月（C组）。研究结束时，所有患者均产生了保护性滴度：第4次肌肉注射后为77.5%，第5次后为12.5%，3.5±0.5（均值±标准误）次皮内接种后为10%。A组的平均抗体滴度为1461±98 mIU/ml，B组为594±684，C组为131±133。总之，我们的两步综合方案使所有患者都产生了抗-HBs保护性滴度。
