不同剂量乙肝基因工程疫苗免疫效果Ｍｅｔａ分析

摘要：目的　探讨３针２０μｇ与３针１０μｇ乙型肝炎（乙肝）基因工程疫苗抗 ＨＢｓ阳转率的差异。方法　
在中国学术期刊全文数据库（ＣＮＫＩ）、万方数据库、国家科技图书文献中心杭州镜像站及维普资讯-中文
科技期刊数据库中以“乙肝ＯＲ 乙型肝炎”及“疫苗”为关键词检索２０００年１月～２０１３年５月国内公开发
表的有关３针２０μｇ与３针１０μｇ乙肝基因工程疫苗全程接种后１个月及１年抗 ＨＢｓ阳转率的文献，采用
Ｓｔａｔａ１０．０软件进行Ｍｅｔａ分析。结果　共纳入１８篇文献，Ｍｅｔａ分析结果显示，全程免疫后１ 个月，３ 针
２０μｇ重组酵母乙肝疫苗抗 ＨＢｓ阳转率显著高于３针１０μｇ重组酵母乙肝疫苗（犣＝２．７８，犘＝０．００５），合
并犚犚为１．０４５ （９５％犆犐：１．０１３～１．０７９）；３ 针２０μｇＣＨＯ 细胞乙肝疫苗抗 ＨＢｓ阳转率显著高于３ 针
１０μｇＣＨＯ 细胞乙肝疫苗（犣＝５．８６，犘＜０．０１），合并犚犚为１．０６５ （９５％犆犐：１．０４３～１．０８８）。全程免疫
后１年，３针２０μｇ与３ 针１０μｇ 重组酵母乙肝疫苗抗 ＨＢｓ阳转率差异有统计学意义（犣＝２．３８，犘＝
０．０１７），合并犚犚为１．１０３ （９５％犆犐：１．０１８～１．１９６）。敏感性分析结果显示结果具有较好的稳定性。未发
现纳入文献存在发表偏倚（犘＞０．０５）。结论　３针２０μｇ乙肝基因工程疫苗免疫效果优于３ 针１０μｇ乙肝
疫苗。
关键词：乙型肝炎；疫苗；Ｍｅｔａ分析；乙型肝炎（乙肝）基因工程疫苗；抗 ＨＢｓ阳转率
中图分类号：Ｒ１８６　　文献标识码：Ａ　　文章编号：１００９ ６６３９ （２０１４）０２ ０１０２ ０７

Meta-analysis on the immunogenicity of different dosages of engineering hepatitis B vaccine

Objective To discuss the difference of positive seroconversion rate of anti HBs between 3 shots of 20 vg and 3 shots of 10 μg engineering hepatitis B vaccine. Methods Using ＂hepatitis B＂ and ＂vaccine＂ as key words to search literatures closely related to the study purpose and published in China National Knowledge Infrastructure （CNKI）, Wanfang Database, The National Science and Technology Library of Hangzhou mir- ror and VIP China Scientific Journal Database. Statal0.0 software was used for Meta-analysis. Results In total, 18 papers were retrieved. Meta-analysis showed that 3 shots 20 μg recombinant yeast hepatitis B vaccine （Z=2.78, P=0.005） and Chinese hamster ovary （CHO） hepatitis B vaccine （Z：5.86, P〈0. 01） trig- gered significant higher rate of antibody positive seroconversion compared to 3 shots of 10μg one month after the full vaccination, with the pooledRR of 1.045 （95%CI： 1. 013-1. 079） and 1. 065 （95%CI： 1.043- 1. 088）. Also, the difference of antibody conversion rate was significant between this two dosages one year after the full vaccination for recombinant yeast hepatitis B （Z= 2.38, P 0. 017）, with the pooled RR of 1. 103 （95 % CI ： 1. 018- 1. 196）. Sensitivity analyses revealed that the result was consistent and no publication bias was found （P〉0.05）. Conclusions Three shots of 20μg engineering hepatitis B vaccine bears better immu- nogenicity than 3 shots of 10 μg.