Benhamou E, Courouce A M, Jungers P, Laplanche A, Degos F, Brangier J, Crosnier J
Clin Nephrol. 1984 Mar;21(3):143-7.
In order to determine whether reinforced vaccinations improve the immune response among uremic patients, three vaccination schedules with hepatitis B surface antigen vaccine (Institut Pasteur Production) were compared. A total of 215 hemodialysis patients treated in HBV free units were randomly allocated to Group I (3 injections of 1 ml), Group II (3 injections of 2 ml) and Group III (4 injections of 1 ml). Immune response was evaluated in 204 patients. The percentages of responders within 12 months after the first injection (greater than = 10 mIU/ml on 2 successive blood specimens) were: 45.6%, 75.0% and 69.4% in Group I, Group II and Group III respectively. The geometric mean peak values of anti-HBs observed 6 months after the first injection among the responders were: 60, 192 and 268 mIU/ml respectively. One month after a booster dose given to 182 patients 14 months after the first injection, anti-HBs levels were 144, 1123, 524 mIU/ml respectively, and the frequency of patients with an anti-HBs titer greater than = 50 mIU/ml was 68%, 82% and 75% respectively. These results led us to discard the use of Protocol I for these immuno-depressed patients while it is quite satisfactory in healthy subjects; they also show that Protocol II and III give better results than Protocol I, but that they cannot be statistically differentiated. We conclude that response rates and anti HBs antibody titers can be significantly improved in chronic hemodialysis patients with reinforced vaccination protocols.
为了确定强化疫苗接种是否能改善尿毒症患者的免疫反应，比较了三种乙肝表面抗原疫苗（巴斯德研究所生产）的接种方案。共有215名在无乙肝单位接受治疗的血液透析患者被随机分配到第一组（3次注射，每次1毫升）、第二组（3次注射，每次2毫升）和第三组（4次注射，每次1毫升）。对204名患者的免疫反应进行了评估。首次注射后12个月内有反应者（连续两份血标本中抗-HBs大于等于10 mIU/ml）的百分比分别为：第一组45.6%，第二组75.0%，第三组69.4%。首次注射后6个月，有反应者中观察到的抗-HBs几何平均峰值分别为：60、192和268 mIU/ml。在首次注射14个月后，对182名患者进行加强剂量注射1个月后，抗-HBs水平分别为144、1123、524 mIU/ml，抗-HBs滴度大于等于50 mIU/ml的患者频率分别为68%、82%和75%。这些结果使我们放弃在这些免疫抑制患者中使用方案I，而该方案在健康受试者中相当令人满意；它们还表明方案II和III比方案I效果更好，但在统计学上无法区分。我们得出结论，强化疫苗接种方案可显著提高慢性血液透析患者的反应率和抗-HBs抗体滴度。
