Nghiên cứu kết quả sinh kháng thể sau tiêm vắc xin phòng viêm gan B ở bệnh nhân thận nhân tạo chu kỳ tại Bệnh viện Hữu Nghị Đa khoa Nghệ An=Evaluation of antibody response post vaccination against viral hepatitis B among patients receiving maintenance hemodialysis at Friendship General Hospital of Nghe An

0 Người đánh giá. Xếp hạng trung bình 0

Tác giả: Phan Hải An Hà, Thị Thùy Linh Nguyễn

Ngôn ngữ: vie

Ký hiệu phân loại:

Thông tin xuất bản: Tạp chí Y học Việt Nam (Tổng hội Y học Việt Nam), 2024

Mô tả vật lý: tr.411-418

Bộ sưu tập: Metadata

ID: 478067

Thêm vào giỏ

Nghiên cứu này đánh giá kết quả sinh kháng thể anti-HBs sau tiêm vắc xin phòng viêm gan B liều đơn và tìm hiểu một số yếu tố ảnh hưởng đến đáp ứng sinh kháng thể ở bệnh nhân thận nhân tạo chu kỳ tại bệnh viện Hữu nghị Đa khoa Nghệ An. Phương pháp nghiên cứu: Nghiên cứu mô tả kết hợp hồi và tiến cứu trên 61 người bệnh lọc thận từ tháng 7/2022 đến tháng 3/2023. Nhóm hồi cứu gồm bệnh nhân đã tiêm đủ vắc xin trước lọc máu, nhóm tiến cứu gồm bệnh nhân HBsAg và/hoặc anti-HBc toàn phần âm tính, anti-HBs <
10 UI/L, không bị bệnh cấp tính. Định lượng anti-HBs cho BN hồi cứu. Các bệnh nhân tiến cứu được tiêm bắp vắc xin Heberbiovac liều 20 μg tháng 0,1,2 và định lượng anti-HBs tháng thứ 3. Nếu kết quả <
10 UI/L tiêm ngay mũi 4 liều 20 μg và định lượng lại anti-HBs vào tháng thứ 4. Kết quả: Có 29 BN hồi cứu và 32 BN tiến cứu, nữ chiếm 42.62%, tuổi trung bình 45.7 + 15.2, trong đó 1/29 BN hồi cứu (3,4%) không còn kháng thể anti-HBs lưu hành ở trung vị thời gian 46 tháng (6-334 tháng) sau tiêm mũi cuối. 78,1% bệnh nhân tiến cứu đáp ứng sinh anti-HBs sau 3 mũi tiêm và 100% đáp ứng kháng thể sau 4 mũi. Trung vị anti-HBs của BN hồi cứu được tiêm mũi 4 cách mũi 3 từ 12 tháng trở xuống và trên 12 tháng tương ứng là 728,6 UI/L (49,89-1000 UI/L) và 82,44 UI/L (6,88-492,9 UI/L). Người dưới 50 tuổi có tỷ lệ đáp ứng 94,3%, cao hơn người từ 50 tuổi trở lên (76,9%). Không có sự khác biệt đáng kể về thời gian lọc máu và chỉ số xét nghiệm giữa các nhóm. Kết luận: Tiêm vắc xin trước lọc máu tạo đáp ứng kháng thể cao và bền vững, tiêm sau lọc máu vẫn đạt 100% đáp ứng sau 4 mũi. Người dưới 50 tuổi đáp ứng tốt hơn.This study evaluated the anti-HBs antibody response following a single-dose hepatitis B vaccine and investigated factors affecting antibody response in hemodialysis patients at Nghe An General Friendship Hospital. Methods: A combined retrospective and prospective study was conducted on 61 dialysis patients from July 2022 to March 2023. The retrospective group included patients who had completed vaccination before dialysis. The prospective group included HBsAg and/or total anti-HBc-negative patients, with anti-HBs <
10 IU/L, and without acute illness. Anti-HBs levels were measured in the retrospective group. Prospective patients received intramuscular Heberbiovac (20 μg) at months 0, 1, and 2, with anti-HBs measured at month 3. If anti-HBs remained <
10 IU/L, a fourth dose was administered, followed by re-evaluation at month 4. Results: The study included 29 retrospective and 32 prospective patients, with females accounting for 42.62% and an average age of 45.7 ± 15.2 years. One retrospective patient (3.4%) had no circulating anti-HBs after a median of 46 months (6-334 months) following the final dose. In the prospective group, 78.1% responded with anti-HBs production after 3 doses, and 100% responded after 4 doses. Median anti-HBs levels for retrospective patients who received a fourth dose within 12 months of the third dose was 728.6 IU/L (49.89-1000 IU/L), and 82.44 IU/L (6.88-492.9 IU/L) for those who received the fourth dose after more than 12 months. Patients under 50 years of age had a higher response rate (94.3%) compared to those aged 50 and above (76.9%). There were no significant differences in dialysis duration or laboratory parameters between groups. Conclusion: Pre-dialysis vaccination induces a strong and sustained antibody response, while post-dialysis vaccination still achieves 100% response after 4 doses. Patients under 50 years old respond better.

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