@庐山市民们，你们关心乙肝疫苗接种常见问题解答来了
<!----><style type="text/css">html{font-size:375%}</style><link href="https://pic.app.shanglushan.com/static/publish/css/style.css?v=1605251010485" rel="stylesheet" position="1" data-qf-origin="/static/publish/css/style.css?v=1605251010485"><div class="preview_article "> <!----> <section data-support="96编辑器" data-style-id="26275" style="font-family: -apple-system, BlinkMacSystemFont, " helvetica="" neue",="" "pingfang="" sc",="" "hiragino="" sans="" gb",="" "microsoft="" yahei="" ui",="" yahei",="" arial,="" sans-serif;="" font-size:="" 17px;="" letter-spacing:="" 0.544px;="" box-sizing:="" border-box="" !important;"=""><section style="margin-top: 10px; margin-bottom: 10px; text-align: left; box-sizing: border-box !important;"><section style="display: inline-block; box-sizing: border-box !important;"><section style="display: flex; justify-content: center; align-items: center; box-sizing: border-box !important;"><section style="margin-top: 9px; padding: 3px 20px; box-sizing: border-box; background-color: rgb(184, 233, 255); border-radius: 5px 0px 0px 5px;"><section style="display: flex; justify-content: center; align-items: center; box-sizing: border-box !important;"><section style="padding-right: 8px; padding-left: 8px; font-family: -apple-system, BlinkMacSystemFont, "Helvetica Neue", "PingFang SC", "Hiragino Sans GB", "Microsoft YaHei UI", "Microsoft YaHei", Arial, sans-serif; font-size: 17px; letter-spacing: 0.544px; width: 25px; height: 25px; background-color: rgb(254, 215, 46); border-radius: 50%; box-sizing: border-box !important;"><p style="clear: both; min-height: 1em; line-height: 25px; letter-spacing: 2px; box-sizing: border-box !important;"><span style="font-size: 15px; color: rgb(14, 37, 255); box-sizing: border-box !important;">1</span></p></section><p style="margin-left: 8px; clear: both; min-height: 1em; letter-spacing: 2px; box-sizing: border-box !important;"><span style="color: rgb(14, 37, 255); font-size: 18px; box-sizing: border-box !important;">为什么说乙肝疫苗是世界上第一个防癌疫苗？</span></p></section></section><section style="margin-top: 9px; box-sizing: border-box; float: left; border-bottom: 32px solid rgb(184, 233, 255); border-left: 0px solid transparent; border-right: 20px solid transparent; height: 0px; width: 0px;"><br style="box-sizing: border-box !important;"></section></section></section><section style="margin-top: -3px; margin-bottom: -3px; transform: rotateZ(0deg); box-sizing: border-box !important;"><section style="padding: 10px 15px; border-top: 3px solid rgb(254, 254, 254); border-bottom: 3px solid rgb(184, 233, 255); border-radius: 15px; box-sizing: border-box !important;"><p style="clear: both; min-height: 1em; text-indent: 32px; line-height: 21px; box-sizing: border-box !important;"><span style="color: black; font-family: 宋体, SimSun; box-sizing: border-box !important;">肝癌（原发性肝癌）是我国常见的癌症，临床上注意到肝癌患者大部分都有急性肝炎-慢性肝炎-肝硬化-肝癌的疾病发展史。可见肝炎与肝癌的关系极为密切。</span></p><span style="font-family: 宋体, SimSun; box-sizing: border-box !important;"><span style="font-family: 宋体; color: black; box-sizing: border-box !important;"> 新生儿感染</span><span style="font-family: Calibri, sans-serif; color: black; box-sizing: border-box !important;">HBV</span><span style="font-family: 宋体; color: black; box-sizing: border-box !important;">后，有</span><span style="font-family: Calibri, sans-serif; color: black; box-sizing: border-box !important;">85%</span><span style="font-family: 宋体; color: black; box-sizing: border-box !important;">以上转变成为慢性携带者，并最终发展成肝硬化和肝癌。乙肝病毒感染是导致肝癌发生的最主要因素，因此，接种乙肝疫苗不仅可以预防乙型肝炎的发生，还能有效控制和减少肝癌疾病的发生。</span></span></section></section></section></section><section data-support="96编辑器" data-style-id="26275" style="font-family: -apple-system, BlinkMacSystemFont, " helvetica="" neue",="" "pingfang="" sc",="" "hiragino="" sans="" gb",="" "microsoft="" yahei="" ui",="" yahei",="" arial,="" sans-serif;="" font-size:="" 17px;="" letter-spacing:="" 0.544px;="" box-sizing:="" border-box="" !important;"=""><section style="margin-top: 10px; margin-bottom: 10px; text-align: left; box-sizing: border-box !important;"><section style="display: inline-block; box-sizing: border-box !important;"><section style="display: flex; justify-content: center; align-items: center; box-sizing: border-box !important;"><section style="margin-top: 9px; padding: 3px 20px; box-sizing: border-box; border-radius: 5px 0px 0px 5px;"><section style="display: flex; justify-content: center; align-items: center; box-sizing: border-box !important;"><section style="padding-right: 8px; padding-left: 8px; background-color: rgb(254, 215, 46); width: 25px; height: 25px; border-radius: 50%; box-sizing: border-box !important;"><p style="clear: both; min-height: 1em; line-height: 25px; letter-spacing: 2px; box-sizing: border-box !important;"><span style="font-size: 15px; color: rgb(14, 37, 255); box-sizing: border-box !important;">2</span></p></section><p style="margin-left: 8px; clear: both; min-height: 1em; letter-spacing: 2px; box-sizing: border-box !important;"><span style="color: rgb(14, 37, 255); font-size: 18px; background-color: rgb(184, 233, 255); box-sizing: border-box !important;">哪些人应该接种乙肝疫苗？</span></p></section></section></section></section><section style="margin-top: -3px; margin-bottom: -3px; transform: rotateZ(0deg); box-sizing: border-box !important;"><section style="padding: 10px 15px; border-top: 3px solid rgb(254, 254, 254); border-bottom: 3px solid rgb(184, 233, 255); border-radius: 15px; box-sizing: border-box !important;"><p style="clear: both; min-height: 1em; text-indent: 32px; line-height: 21px; background-image: initial; background-position: initial; background-size: initial; background-repeat: initial; background-attachment: initial; background-origin: initial; background-clip: initial; box-sizing: border-box !important;"><span style="color: black; font-family: 宋体, SimSun; box-sizing: border-box !important;">接种对象包括所有未接种或者未全程接种乙肝疫苗或接种史不详的及所有自愿接种乙肝疫苗的人。尤其是存在以下风险的人群:</span></p><p style="clear: both; min-height: 1em; text-indent: 32px; line-height: 21px; background-image: initial; background-position: initial; background-size: initial; background-repeat: initial; background-attachment: initial; background-origin: initial; background-clip: initial; box-sizing: border-box !important;"><span style="font-family: 宋体, SimSun; color: black; box-sizing: border-box !important;">1、存在性暴露感染风险的人群；</span></p><p style="clear: both; min-height: 1em; text-indent: 32px; line-height: 21px; background-image: initial; background-position: initial; background-size: initial; background-repeat: initial; background-attachment: initial; background-origin: initial; background-clip: initial; box-sizing: border-box !important;"><span style="font-family: 宋体, SimSun; color: black; box-sizing: border-box !important;">2、存在职业暴露风险的人群:如医学院校学生、接触血液的医务工作者等；</span></p><p style="clear: both; min-height: 1em; text-indent: 32px; line-height: 21px; background-image: initial; background-position: initial; background-size: initial; background-repeat: initial; background-attachment: initial; background-origin: initial; background-clip: initial; box-sizing: border-box !important;"><span style="font-family: 宋体, SimSun; color: black; box-sizing: border-box !important;">3、存在经皮肤和黏膜暴露血液风险的人群:如 HBSAg携带者或乙肝患者的家庭成员；</span></p><p style="clear: both; min-height: 1em; text-indent: 32px; line-height: 21px; background-image: initial; background-position: initial; background-size: initial; background-repeat: initial; background-attachment: initial; background-origin: initial; background-clip: initial; box-sizing: border-box !important;"><span style="font-family: 宋体, SimSun; color: black; box-sizing: border-box !important;">4、其他人群:如糖尿病人群、集体生活的大学生人群等。</span></p><span style="font-size: 14px; font-family: 宋体; color: black; box-sizing: border-box !important;"></span></section></section></section></section><section data-support="96编辑器" data-style-id="26275" style="font-family: -apple-system, BlinkMacSystemFont, " helvetica="" neue",="" "pingfang="" sc",="" "hiragino="" sans="" gb",="" "microsoft="" yahei="" ui",="" yahei",="" arial,="" sans-serif;="" font-size:="" 17px;="" letter-spacing:="" 0.544px;="" box-sizing:="" border-box="" !important;"=""><section style="margin-top: 10px; margin-bottom: 10px; text-align: left; box-sizing: border-box !important;"><section style="display: inline-block; box-sizing: border-box !important;"><section style="display: flex; justify-content: center; align-items: center; box-sizing: border-box !important;"><section style="margin-top: 9px; padding: 3px 20px; box-sizing: border-box; background-color: rgb(184, 233, 255); border-radius: 5px 0px 0px 5px;"><section style="display: flex; justify-content: center; align-items: center; box-sizing: border-box !important;"><section style="padding-right: 8px; padding-left: 8px; width: 25px; height: 25px; background-color: rgb(254, 215, 46); border-radius: 50%; box-sizing: border-box !important;"><p style="clear: both; min-height: 1em; line-height: 25px; letter-spacing: 2px; box-sizing: border-box !important;"><span style="font-size: 15px; color: rgb(14, 37, 255); box-sizing: border-box !important;">3</span></p></section><p style="margin-left: 8px; clear: both; min-height: 1em; letter-spacing: 2px; box-sizing: border-box !important;"><span style="color: rgb(14, 37, 255); font-size: 18px; box-sizing: border-box !important;">乙肝疫苗为什么要接种三针？</span></p></section></section><section style="margin-top: 9px; box-sizing: border-box; float: left; border-bottom: 32px solid rgb(184, 233, 255); border-left: 0px solid transparent; border-right: 20px solid transparent; height: 0px; width: 0px;"><br style="box-sizing: border-box !important;"></section></section></section><section style="margin-top: -3px; margin-bottom: -3px; transform: rotateZ(0deg); box-sizing: border-box !important;"><section style="padding: 10px 15px; border-top: 3px solid rgb(254, 254, 254); border-bottom: 3px solid rgb(184, 233, 255); border-radius: 15px; box-sizing: border-box !important;"><p style="clear: both; min-height: 1em; text-indent: 32px; line-height: 21px; background-image: initial; background-position: initial; background-size: initial; background-repeat: initial; background-attachment: initial; background-origin: initial; background-clip: initial; box-sizing: border-box !important;"><span style="color: black; font-family: 宋体, SimSun; box-sizing: border-box !important;">乙肝疫苗是非活疫苗，不能在内复制，3针的每一针都发挥着不同的作用，只有经多次注射才能刺激机体产生足够、持久的抗体，使受种者得到保护。经观察证实，接种1剂乙肝疫苗只有50％的人产生保护性抗体，如果感染HBV量大仍可发生感染。接种2剂抗体阳转率可≥80％，接种3剂才能达到95％以上。</span></p><span style="font-size: 14px; font-family: 宋体; color: black; box-sizing: border-box !important;"></span></section></section></section></section><section data-support="96编辑器" data-style-id="26275" style="font-family: -apple-system, BlinkMacSystemFont, " helvetica="" neue",="" "pingfang="" sc",="" "hiragino="" sans="" gb",="" "microsoft="" yahei="" ui",="" yahei",="" arial,="" sans-serif;="" font-size:="" 17px;="" letter-spacing:="" 0.544px;="" box-sizing:="" border-box="" !important;"=""><section style="margin-top: 10px; margin-bottom: 10px; text-align: left; box-sizing: border-box !important;"><section style="display: inline-block; box-sizing: border-box !important;"><section style="display: flex; justify-content: center; align-items: center; box-sizing: border-box !important;"><section style="margin-top: 9px; padding: 3px 20px; box-sizing: border-box; background-color: rgb(184, 233, 255); border-radius: 5px 0px 0px 5px;"><section style="display: flex; justify-content: center; align-items: center; box-sizing: border-box !important;"><section style="padding-right: 8px; padding-left: 8px; width: 25px; height: 25px; background-color: rgb(254, 215, 46); border-radius: 50%; box-sizing: border-box !important;"><p style="clear: both; min-height: 1em; line-height: 25px; letter-spacing: 2px; box-sizing: border-box !important;"><span style="font-size: 15px; color: rgb(14, 37, 255); box-sizing: border-box !important;">4</span></p></section><p style="margin-left: 8px; clear: both; min-height: 1em; letter-spacing: 2px; box-sizing: border-box !important;"><span style="color: rgb(14, 37, 255); font-size: 18px; box-sizing: border-box !important;">乙肝疫苗为什么推荐上臂三角肌接种？</span></p></section></section><section style="margin-top: 9px; box-sizing: border-box; float: left; border-bottom: 32px solid rgb(184, 233, 255); border-left: 0px solid transparent; border-right: 20px solid transparent; height: 0px; width: 0px;"><br style="box-sizing: border-box !important;"></section></section></section><section style="margin-top: -3px; margin-bottom: -3px; transform: rotateZ(0deg); box-sizing: border-box !important;"><section style="padding: 10px 15px; border-top: 3px solid rgb(254, 254, 254); border-bottom: 3px solid rgb(184, 233, 255); border-radius: 15px; box-sizing: border-box !important;"><p style="clear: both; min-height: 1em; text-indent: 32px; line-height: 21px; background-image: initial; background-position: initial; background-size: initial; background-repeat: initial; background-attachment: initial; background-origin: initial; background-clip: initial; box-sizing: border-box !important;"><span style="color: black; font-family: 宋体, SimSun; box-sizing: border-box !important;">肌内注射是乙肝疫苗最佳免疫途径，上臂三角肌肌肉发达，血管少，皮下脂肪层薄，接种疫苗后能很快被吸收，是接种乙肝疫苗的最佳途径。臀部皮下脂肪厚，易将疫苗注射于脂肪层内，脂肪层的血液循环较差，减少了吞噬细胞与抗原接触，使疫苗吸收较慢，影响将处理后的抗原转移给免疫活性细胞，对疫苗的免疫效果有一定的影响，同时容易损伤神经。</span></p><span style="font-size: 14px; font-family: 宋体; color: black; box-sizing: border-box !important;"></span></section></section></section></section><section data-support="96编辑器" data-style-id="26275" style="font-family: -apple-system, BlinkMacSystemFont, " helvetica="" neue",="" "pingfang="" sc",="" "hiragino="" sans="" gb",="" "microsoft="" yahei="" ui",="" yahei",="" arial,="" sans-serif;="" font-size:="" 17px;="" letter-spacing:="" 0.544px;="" box-sizing:="" border-box="" !important;"=""><section style="margin-top: 10px; margin-bottom: 10px; text-align: left; box-sizing: border-box !important;"><section style="display: inline-block; box-sizing: border-box !important;"><section style="display: flex; justify-content: center; align-items: center; box-sizing: border-box !important;"><section style="margin-top: 9px; padding: 3px 20px; box-sizing: border-box; background-color: rgb(184, 233, 255); border-radius: 5px 0px 0px 5px;"><section style="display: flex; justify-content: center; align-items: center; box-sizing: border-box !important;"><section style="padding-right: 8px; padding-left: 8px; width: 25px; height: 25px; background-color: rgb(254, 215, 46); border-radius: 50%; box-sizing: border-box !important;"><p style="clear: both; min-height: 1em; line-height: 25px; letter-spacing: 2px; box-sizing: border-box !important;"><span style="font-size: 15px; color: rgb(14, 37, 255); box-sizing: border-box !important;">5</span></p></section><p style="margin-left: 8px; clear: both; min-height: 1em; letter-spacing: 2px; box-sizing: border-box !important;"><span style="color: rgb(14, 37, 255); font-size: 18px; box-sizing: border-box !important;">目前我市使用的乙肝疫苗主要有哪些？</span></p></section></section><section style="margin-top: 9px; box-sizing: border-box; float: left; border-bottom: 32px solid rgb(184, 233, 255); border-left: 0px solid transparent; border-right: 20px solid transparent; height: 0px; width: 0px;"><br style="box-sizing: border-box !important;"></section></section></section><section style="margin-top: -3px; margin-bottom: -3px; transform: rotateZ(0deg); box-sizing: border-box !important;"><section style="padding: 10px 15px; border-top: 3px solid rgb(254, 254, 254); border-bottom: 3px solid rgb(184, 233, 255); border-radius: 15px; box-sizing: border-box !important;"><p style="clear: both; min-height: 1em; text-indent: 32px; line-height: 21px; background-image: initial; background-position: initial; background-size: initial; background-repeat: initial; background-attachment: initial; background-origin: initial; background-clip: initial; box-sizing: border-box !important;"><span style="font-family: 宋体, SimSun; color: black; box-sizing: border-box !important;">10μg重组（酵母）乙肝疫苗，主要用于新生儿全程常规免疫接种；20μg重组（CHO细胞）乙肝疫苗,可用于HBSAg阳性母亲所生新生儿及其他乙型肝炎易感人群；60μg适用于乙型肝炎疫苗常规免疫无应答的16岁及以上年龄的乙型肝炎易感者。</span></p><span style="font-size: 14px; font-family: 宋体; color: black; box-sizing: border-box !important;"></span></section></section></section></section><section data-support="96编辑器" data-style-id="26275" style="font-family: -apple-system, BlinkMacSystemFont, " helvetica="" neue",="" "pingfang="" sc",="" "hiragino="" sans="" gb",="" "microsoft="" yahei="" ui",="" yahei",="" arial,="" sans-serif;="" font-size:="" 17px;="" letter-spacing:="" 0.544px;="" box-sizing:="" border-box="" !important;"=""><section style="margin-top: 10px; margin-bottom: 10px; text-align: left; box-sizing: border-box !important;"><section style="display: inline-block; box-sizing: border-box !important;"><section style="display: flex; justify-content: center; align-items: center; box-sizing: border-box !important;"><section style="margin-top: 9px; padding: 3px 20px; box-sizing: border-box; background-color: rgb(184, 233, 255); border-radius: 5px 0px 0px 5px;"><section style="display: flex; justify-content: center; align-items: center; box-sizing: border-box !important;"><section style="padding-right: 8px; padding-left: 8px; width: 25px; height: 25px; background-color: rgb(254, 215, 46); border-radius: 50%; box-sizing: border-box !important;"><p style="clear: both; min-height: 1em; line-height: 25px; letter-spacing: 2px; box-sizing: border-box !important;"><span style="color: rgb(14, 37, 255); box-sizing: border-box !important;"><span style="font-size: 15px; box-sizing: border-box !important;">6</span></span></p></section><p style="margin-left: 8px; clear: both; min-height: 1em; letter-spacing: 2px; box-sizing: border-box !important;"><span style="color: rgb(14, 37, 255); font-size: 18px; box-sizing: border-box !important;">采取怎样的措施来提高母婴阻断成功率？</span></p></section></section><section style="margin-top: 9px; box-sizing: border-box; float: left; border-bottom: 32px solid rgb(184, 233, 255); border-left: 0px solid transparent; border-right: 20px solid transparent; height: 0px; width: 0px;"><br style="box-sizing: border-box !important;"></section></section></section><section style="margin-top: -3px; margin-bottom: -3px; transform: rotateZ(0deg); box-sizing: border-box !important;"><section style="padding: 10px 15px; border-top: 3px solid rgb(254, 254, 254); border-bottom: 3px solid rgb(184, 233, 255); border-radius: 15px; box-sizing: border-box !important;"><p style="clear: both; min-height: 1em; text-indent: 32px; line-height: 21px; background-image: initial; background-position: initial; background-size: initial; background-repeat: initial; background-attachment: initial; background-origin: initial; background-clip: initial; box-sizing: border-box !important;"><span style="color: black; font-family: 宋体, SimSun; box-sizing: border-box !important;">对 HBSAg阳性母亲所生新生儿，应在出生后24h内尽早（最好在出生后12h）注射HBIG，剂量应≥100IU，同时在不同部位接种10μg重组酵母乙型肝炎疫苗或20μg重组乙型肝炎疫苗（CHO细胞），在1个月和6个月时分别接种第2和第3针乙型肝炎疫苗，可显著提高母婴传播的阻断成功率。</span></p><span style="font-size: 14px; font-family: 宋体; color: black; box-sizing: border-box !important;"></span></section></section></section></section><section data-support="96编辑器" data-style-id="26275" style="font-family: -apple-system, BlinkMacSystemFont, " helvetica="" neue",="" "pingfang="" sc",="" "hiragino="" sans="" gb",="" "microsoft="" yahei="" ui",="" yahei",="" arial,="" sans-serif;="" font-size:="" 17px;="" letter-spacing:="" 0.544px;="" box-sizing:="" border-box="" !important;"=""><section style="margin-top: 10px; margin-bottom: 10px; text-align: left; box-sizing: border-box !important;"><section style="display: inline-block; box-sizing: border-box !important;"><section style="display: flex; justify-content: center; align-items: center; box-sizing: border-box !important;"><section style="margin-top: 9px; padding: 3px 20px; box-sizing: border-box; background-color: rgb(184, 233, 255); border-radius: 5px 0px 0px 5px;"><section style="display: flex; justify-content: center; align-items: center; box-sizing: border-box !important;"><section style="padding-right: 8px; padding-left: 8px; width: 25px; height: 25px; background-color: rgb(254, 215, 46); border-radius: 50%; box-sizing: border-box !important;"><p style="clear: both; min-height: 1em; line-height: 25px; letter-spacing: 2px; box-sizing: border-box !important;"><span style="color: rgb(14, 37, 255); box-sizing: border-box !important;"><span style="font-size: 15px; box-sizing: border-box !important;">7</span></span></p></section><p style="margin-left: 8px; clear: both; min-height: 1em; letter-spacing: 2px; box-sizing: border-box !important;"><span style="color: rgb(14, 37, 255); font-size: 18px; box-sizing: border-box !important;">低应答/无应答人群如何进行乙肝疫苗接种？</span></p></section></section><section style="margin-top: 9px; box-sizing: border-box; float: left; border-bottom: 32px solid rgb(184, 233, 255); border-left: 0px solid transparent; border-right: 20px solid transparent; height: 0px; width: 0px;"><br style="box-sizing: border-box !important;"></section></section></section><section style="margin-top: -3px; margin-bottom: -3px; transform: rotateZ(0deg); box-sizing: border-box !important;"><section style="padding: 10px 15px; border-top: 3px solid rgb(254, 254, 254); border-bottom: 3px solid rgb(184, 233, 255); border-radius: 15px; box-sizing: border-box !important;"><p style="clear: both; min-height: 1em; text-indent: 32px; line-height: 21px; box-sizing: border-box !important;"><span style="color: black; font-family: 宋体, SimSun; box-sizing: border-box !important;">全程接种乙肝疫苗后，绝大多数接种者体内可产生高滴度的保护性抗体。但在我们的实际接种工作中，也会经常遇到接种乙肝疫苗后无抗-HBs产生的情况发生，这种现象称为无应答；而低应答是指抗-HBs＜10mIU/ml 。</span></p><p style="clear: both; min-height: 1em; text-indent: 32px; line-height: 21px; box-sizing: border-box !important;"><span style="color: black; font-family: 宋体, SimSun; box-sizing: border-box !important;">低、无应答的机制尚未明确，主要有以下几个可能因素：遗传、免疫功能异常、乙肝病毒变异、机体己发生隐匿性感染、检测方法不敏感，另外统计分析显示，年龄、接种部位、吸烟、饮酒、母亲血清中的病毒含量以及使用的疫苗类型和接种剂量均与无/低应答有关。此外，艾滋病、器官移植、血液透析、糖尿病、恶性肿瘤、营养不良等疾病会导致受种者免疫功能障碍，也可能引起无/低免疫应答。</span></p><p style="clear: both; min-height: 1em; text-indent: 32px; line-height: 21px; box-sizing: border-box !important;"><span style="color: black; font-family: 宋体, SimSun; box-sizing: border-box !important;">对于低无应答人群进行乙肝疫苗接种的建议如下：</span></p><p style="clear: both; min-height: 1em; text-indent: 32px; line-height: 21px; box-sizing: border-box !important;"><span style="color: black; font-family: 宋体, SimSun; box-sizing: border-box !important;">①更换疫苗种类</span></p><p style="clear: both; min-height: 1em; text-indent: 32px; line-height: 21px; box-sizing: border-box !important;"><span style="color: black; font-family: 宋体, SimSun; box-sizing: border-box !important;">目前我国使用的乙肝疫苗有3种，如接种某一种疫苗发生无/低应答，可更换接种另一种疫苗。例如接种重组乙型肝炎疫苗（啤酒酵母）、重组乙型肝炎疫苗（汉逊酵母）出现低无应答，可更换重组乙型肝炎疫苗（CHO细胞）。</span></p><p style="clear: both; min-height: 1em; text-indent: 32px; line-height: 21px; box-sizing: border-box !important;"><span style="color: black; font-family: 宋体, SimSun; box-sizing: border-box !important;">②增加接种剂次</span></p><p style="clear: both; min-height: 1em; text-indent: 32px; line-height: 21px; box-sizing: border-box !important;"><span style="color: black; font-family: 宋体, SimSun; box-sizing: border-box !important;">研究表明，对初次免疫无应答者再接种1剂后，有15％～25％的人可产生保护性抗体；如再继续接种3剂，大部分人可产生保护性抗体；但是，对于经第2次完成3剂全程免疫仍然不产生抗体者，在两次全程接种后（6剂），不推荐再次进行接种。</span></p><p style="clear: both; min-height: 1em; text-indent: 32px; line-height: 21px; box-sizing: border-box !important;"><span style="color: black; font-family: 宋体, SimSun; box-sizing: border-box !important;">③增加接种剂量</span></p><span style="font-family: 宋体, SimSun; box-sizing: border-box !important;"><span style="font-family: 宋体; color: black; box-sizing: border-box !important;"> 例如原来接种</span><span style="font-family: Calibri, sans-serif; color: black; box-sizing: border-box !important;">10</span><span style="font-family: 宋体; color: black; box-sizing: border-box !important;">μ</span><span style="font-family: Calibri, sans-serif; color: black; box-sizing: border-box !important;">g</span><span style="font-family: 宋体; color: black; box-sizing: border-box !important;">剂量的乙肝疫苗无抗体产生，可尝试接种高于</span><span style="font-family: Calibri, sans-serif; color: black; box-sizing: border-box !important;">10</span><span style="font-family: 宋体; color: black; box-sizing: border-box !important;">μ</span><span style="font-family: Calibri, sans-serif; color: black; box-sizing: border-box !important;">g</span><span style="font-family: 宋体; color: black; box-sizing: border-box !important;">的剂量。</span></span></section></section></section></section><section data-support="96编辑器" data-style-id="26275" style="font-family: -apple-system, BlinkMacSystemFont, " helvetica="" neue",="" "pingfang="" sc",="" "hiragino="" sans="" gb",="" "microsoft="" yahei="" ui",="" yahei",="" arial,="" sans-serif;="" font-size:="" 17px;="" letter-spacing:="" 0.544px;="" box-sizing:="" border-box="" !important;"=""><section style="margin-top: 10px; margin-bottom: 10px; text-align: left; box-sizing: border-box !important;"><section style="display: inline-block; box-sizing: border-box !important;"><section style="display: flex; justify-content: center; align-items: center; box-sizing: border-box !important;"><section style="margin-top: 9px; padding: 3px 20px; box-sizing: border-box; background-color: rgb(184, 233, 255); border-radius: 5px 0px 0px 5px;"><section style="display: flex; justify-content: center; align-items: center; box-sizing: border-box !important;"><section style="padding-right: 8px; padding-left: 8px; width: 25px; height: 25px; background-color: rgb(254, 215, 46); border-radius: 50%; box-sizing: border-box !important;"><p style="clear: both; min-height: 1em; line-height: 25px; letter-spacing: 2px; box-sizing: border-box !important;"><span style="color: rgb(14, 37, 255); box-sizing: border-box !important;"><span style="font-size: 15px; box-sizing: border-box !important;">8</span></span></p></section><p style="margin-left: 8px; clear: both; min-height: 1em; letter-spacing: 2px; box-sizing: border-box !important;"><span style="color: rgb(14, 37, 255); font-size: 18px; box-sizing: border-box !important;">患有下列特殊疾病的新生儿能否接种乙肝疫苗？</span></p></section></section><section style="margin-top: 9px; box-sizing: border-box; float: left; border-bottom: 32px solid rgb(184, 233, 255); border-left: 0px solid transparent; border-right: 20px solid transparent; height: 0px; width: 0px;"><br style="box-sizing: border-box !important;"></section></section></section><section style="margin-top: -3px; margin-bottom: -3px; transform: rotateZ(0deg); box-sizing: border-box !important;"><section style="padding: 10px 15px; border-top: 3px solid rgb(254, 254, 254); border-bottom: 3px solid rgb(184, 233, 255); border-radius: 15px; box-sizing: border-box !important;"><p style="clear: both; min-height: 1em; text-indent: 32px; line-height: 21px; box-sizing: border-box !important;"><span style="color: black; font-family: 宋体, SimSun; box-sizing: border-box !important;">先天性心脏病：要看患儿心脏功能是否正常，同时结合体重增加速率、体格发育是否正常，如果均正常，是可以正常接种乙肝疫苗的。</span></p><p style="clear: both; min-height: 1em; text-indent: 32px; line-height: 21px; box-sizing: border-box !important;"><span style="color: black; font-family: 宋体, SimSun; box-sizing: border-box !important;">血友病：因血友病发病机制与机体免疫系统无直接相关性，可以接种乙肝疫苗。但是，要尽量使用最小号针头减少创伤，要按压局部来回按揉避免损伤扩大，接种后要密切观察24小时，建议家长接种前给孩子输注所缺的凝血因子。</span></p><p style="clear: both; min-height: 1em; text-indent: 32px; line-height: 21px; box-sizing: border-box !important;"><span style="color: black; font-family: 宋体, SimSun; box-sizing: border-box !important;">蚕豆病：因蚕豆病发病机制与机体免疫系统无直接相关性，可以接种乙肝疫苗。同时国外文献也报道蚕豆病的孩子可以正常接种甲肝疫苗和乙肝疫苗。我国南方地区蚕豆病患儿相对较多，但都在进行正常的疫苗接种，未发现AEFI的发生几率较正常儿童增加。所以蚕豆病患儿可以正常接种乙肝疫苗。</span></p><p style="clear: both; min-height: 1em; text-indent: 32px; line-height: 21px; box-sizing: border-box !important;"><span style="color: black; font-family: 宋体, SimSun; box-sizing: border-box !important;">地中海贫血：因地中海贫血发病机制与机体免疫系统无直接相关性，可以接种乙肝疫苗。但是如正处于中重度贫血期间，应先纠正，当回复到轻度贫血时再接种。</span></p><p style="clear: both; min-height: 1em; text-indent: 32px; line-height: 21px; box-sizing: border-box !important;"><span style="color: black; font-family: 宋体, SimSun; box-sizing: border-box !important;">粘多糖症：需先检测免疫功能，根据免疫功能情况进行预防接种工作。</span></p><p style="clear: both; min-height: 1em; text-indent: 32px; line-height: 21px; box-sizing: border-box !important;"><span style="color: black; font-family: 宋体, SimSun; box-sizing: border-box !important;">先天性甲低：只要能确定无免疫功能异常，就可以正常接种乙肝疫苗。</span></p><p style="clear: both; min-height: 1em; text-indent: 32px; line-height: 21px; box-sizing: border-box !important;"><span style="font-family: 宋体, SimSun; color: black; box-sizing: border-box !important;">21-三体综合症：智力发育落后，很可能会合并多脏器的先天性缺损，出现继发的免疫功能低下和甲低等问题，在接种工作中要谨慎，要认真筛选确认，再根据结果决定能否进行乙肝疫苗接种。</span></p><span style="color: black; font-family: 宋体, SimSun; box-sizing: border-box !important;"> 先天性脑积水：如脑积水程度较轻，未对大脑造成实质性挤压，智力测评智力发育水平与正常儿童接近，建议正常进行乙肝疫苗接种。</span><span style="font-size: 14px; font-family: 宋体; color: black; box-sizing: border-box !important;"></span></section></section></section></section><section data-support="96编辑器" data-style-id="26275" style="font-family: -apple-system, BlinkMacSystemFont, " helvetica="" neue",="" "pingfang="" sc",="" "hiragino="" sans="" gb",="" "microsoft="" yahei="" ui",="" yahei",="" arial,="" sans-serif;="" font-size:="" 17px;="" letter-spacing:="" 0.544px;="" box-sizing:="" border-box="" !important;"=""><section style="margin-top: 10px; margin-bottom: 10px; text-align: left; box-sizing: border-box !important;"><section style="display: inline-block; box-sizing: border-box !important;"><section style="display: flex; justify-content: center; align-items: center; box-sizing: border-box !important;"><section style="margin-top: 9px; padding: 3px 20px; box-sizing: border-box; background-color: rgb(184, 233, 255); border-radius: 5px 0px 0px 5px;"><section style="display: flex; justify-content: center; align-items: center; box-sizing: border-box !important;"><section style="padding-right: 8px; padding-left: 8px; width: 25px; height: 25px; background-color: rgb(254, 215, 46); border-radius: 50%; box-sizing: border-box !important;"><p style="clear: both; min-height: 1em; line-height: 25px; letter-spacing: 2px; box-sizing: border-box !important;"><span style="color: rgb(14, 37, 255); box-sizing: border-box !important;"><span style="font-size: 15px; box-sizing: border-box !important;">9</span></span></p></section><p style="margin-left: 8px; clear: both; min-height: 1em; letter-spacing: 2px; box-sizing: border-box !important;"><span style="color: rgb(14, 37, 255); font-size: 18px; box-sizing: border-box !important;">抗-HBS阳性、弱阳性和阳性的标准是什么？</span></p></section></section><section style="margin-top: 9px; box-sizing: border-box; float: left; border-bottom: 32px solid rgb(184, 233, 255); border-left: 0px solid transparent; border-right: 20px solid transparent; height: 0px; width: 0px;"><br style="box-sizing: border-box !important;"><br style="box-sizing: border-box !important;"></section></section></section><section style="margin-top: -3px; margin-bottom: -3px; transform: rotateZ(0deg); box-sizing: border-box !important;"><section style="padding: 10px 15px; border-top: 3px solid rgb(254, 254, 254); border-bottom: 3px solid rgb(184, 233, 255); border-radius: 15px; box-sizing: border-box !important;"><p style="clear: both; min-height: 1em; text-indent: 32px; line-height: 21px; background-image: initial; background-position: initial; background-size: initial; background-repeat: initial; background-attachment: initial; background-origin: initial; background-clip: initial; box-sizing: border-box !important;"><span style="color: black; font-family: 宋体, SimSun; box-sizing: border-box !important;">乙肝表面抗体滴度大于100mIU/ml为阳性；乙肝表面抗体滴度在10mIU/ml-100mIU/ml之间为弱阳性；乙肝表面抗体滴度在10mIU/ml以下为阴性。一般认为，体内乙肝抗体滴度<10mIU/ml时将得不到有效保护。</span></p><span style="font-size: 14px; font-family: 宋体; color: black; box-sizing: border-box !important;"></span></section></section></section></section><section data-support="96编辑器" data-style-id="26275" style="font-family: -apple-system, BlinkMacSystemFont, " helvetica="" neue",="" "pingfang="" sc",="" "hiragino="" sans="" gb",="" "microsoft="" yahei="" ui",="" yahei",="" arial,="" sans-serif;="" font-size:="" 17px;="" letter-spacing:="" 0.544px;="" box-sizing:="" border-box="" !important;"=""><section style="margin-top: 10px; margin-bottom: 10px; text-align: left; box-sizing: border-box !important;"><section style="display: inline-block; box-sizing: border-box !important;"><section style="display: flex; justify-content: center; align-items: center; box-sizing: border-box !important;"><section style="margin-top: 9px; padding: 3px 20px; box-sizing: border-box; background-color: rgb(184, 233, 255); border-radius: 5px 0px 0px 5px;"><section style="display: flex; justify-content: center; align-items: center; box-sizing: border-box !important;"><section style="padding-right: 8px; padding-left: 8px; width: 25px; height: 25px; background-color: rgb(254, 215, 46); border-radius: 50%; box-sizing: border-box !important;"><p style="clear: both; min-height: 1em; line-height: 25px; letter-spacing: 2px; box-sizing: border-box !important;"><span style="color: rgb(14, 37, 255); box-sizing: border-box !important;"><span style="font-size: 15px; box-sizing: border-box !important;">10</span></span></p></section><p style="margin-left: 8px; clear: both; min-height: 1em; letter-spacing: 2px; box-sizing: border-box !important;"><span style="color: rgb(14, 37, 255); font-size: 18px; box-sizing: border-box !important;">乙肝疫苗如何进行加强接种？</span></p></section></section><section style="margin-top: 9px; box-sizing: border-box; float: left; border-bottom: 32px solid rgb(184, 233, 255); border-left: 0px solid transparent; border-right: 20px solid transparent; height: 0px; width: 0px;"><br style="box-sizing: border-box !important;"><br style="box-sizing: border-box !important;"></section></section></section><section style="margin-top: -3px; margin-bottom: -3px; transform: rotateZ(0deg); box-sizing: border-box !important;"><section style="padding: 10px 15px; border-top: 3px solid rgb(254, 254, 254); border-bottom: 3px solid rgb(184, 233, 255); border-radius: 15px; box-sizing: border-box !important;"><p style="clear: both; min-height: 1em; text-indent: 32px; line-height: 21px; background-image: initial; background-position: initial; background-size: initial; background-repeat: initial; background-attachment: initial; background-origin: initial; background-clip: initial; box-sizing: border-box !important;"><span style="color: black; font-family: 宋体, SimSun; box-sizing: border-box !important;"></span></p><p style="clear: both; min-height: 1em; text-indent: 32px; line-height: 21px; box-sizing: border-box !important;"><span style="color: black; font-family: 宋体, SimSun; box-sizing: border-box !important;">关于完成了HepB三针免疫后是否需要进行加强免疫目前颇有争议：一种观点认为完成了HepB基础免疫后，大部分人群可产生免疫记忆反应，即使暴露时由于免疫记忆细胞的存在，能够迅速产生抗体形成保护，从而不需要进行乙肝疫苗的加强免疫。但目前关于免疫记忆反应的研究，个体产生免疫记忆反应的强弱等问题尚不明确。因此针对个体是否具有免疫记忆反应，也有观点认为，应对完成了基础免疫后的抗体阴性者加强接种一针乙肝疫苗，一周后进行抗体检测如抗体迅速升高，证明该个体具有免疫记忆，无需再加强接种乙肝疫苗；如若接种一周后检测抗体水平未见明显升高，证明该个体不具有免疫记忆，仍需进行三针全程加强接种。</span></p><span style="font-family: 宋体, SimSun; box-sizing: border-box !important;"><span style="font-family: 宋体; color: black; box-sizing: border-box !important;"> 另一种观点认为我国是乙肝大国，乙肝感染风险较大。即使完成了</span><span style="font-family: Calibri, sans-serif; color: black; box-sizing: border-box !important;">HepB</span><span style="font-family: 宋体; color: black; box-sizing: border-box !important;">的基础免疫，为更好的保护目标人群，需要始终维持体内的抗体水平，如果抗体检测结果为阴性，需要加强接种三针乙肝疫苗；如果抗体检测结果为弱阳性，仅需加强接种一针即可。</span></span><span style="font-size: 14px; font-family: 宋体; color: black; box-sizing: border-box !important;"></span></section></section></section></section><section data-support="96编辑器" data-style-id="26275" style="font-family: -apple-system, BlinkMacSystemFont, " helvetica="" neue",="" "pingfang="" sc",="" "hiragino="" sans="" gb",="" "microsoft="" yahei="" ui",="" yahei",="" arial,="" sans-serif;="" font-size:="" 17px;="" letter-spacing:="" 0.544px;="" box-sizing:="" border-box="" !important;"=""><section style="margin-top: 10px; margin-bottom: 10px; text-align: left; box-sizing: border-box !important;"><section style="display: inline-block; box-sizing: border-box !important;"><section style="display: flex; justify-content: center; align-items: center; box-sizing: border-box !important;"><section style="margin-top: 9px; padding: 3px 20px; box-sizing: border-box; background-color: rgb(184, 233, 255); border-radius: 5px 0px 0px 5px;"><section style="display: flex; justify-content: center; align-items: center; box-sizing: border-box !important;"><section style="padding-right: 8px; padding-left: 8px; width: 25px; height: 25px; background-color: rgb(254, 215, 46); border-radius: 50%; box-sizing: border-box !important;"><p style="clear: both; min-height: 1em; line-height: 25px; letter-spacing: 2px; box-sizing: border-box !important;"><span style="color: rgb(14, 37, 255); box-sizing: border-box !important;"><span style="font-size: 15px; box-sizing: border-box !important;">11</span></span></p></section><p style="margin-left: 8px; clear: both; min-height: 1em; letter-spacing: 2px; box-sizing: border-box !important;"><span style="color: rgb(14, 37, 255); font-size: 18px; box-sizing: border-box !important;">HBSAg阳性母亲能否进行母乳喂养？</span></p></section></section><section style="margin-top: 9px; box-sizing: border-box; float: left; border-bottom: 32px solid rgb(184, 233, 255); border-left: 0px solid transparent; border-right: 20px solid transparent; height: 0px; width: 0px;"><br style="box-sizing: border-box !important;"><br style="box-sizing: border-box !important;"></section></section></section><section style="margin-top: -3px; margin-bottom: -3px; transform: rotateZ(0deg); box-sizing: border-box !important;"><section style="padding: 10px 15px; border-top: 3px solid rgb(254, 254, 254); border-bottom: 3px solid rgb(184, 233, 255); border-radius: 15px; box-sizing: border-box !important;"><p style="clear: both; min-height: 1em; text-indent: 32px; line-height: 21px; background-image: initial; background-position: initial; background-size: initial; background-repeat: initial; background-attachment: initial; background-origin: initial; background-clip: initial; box-sizing: border-box !important;"><span style="color: black; font-family: 宋体, SimSun; box-sizing: border-box !important;">一种意见认为，目前使用PCR法检测已证实母乳中也含有HBSAg、 HbeAg和 HBV DNA，感染HBV的产妇进行母乳喂养，理论上推测病毒可能通过婴儿破损的口腔或消化道黏膜进入体内，从而可能引起新生儿感染，认为不能进行母乳喂养。另一种意见认为，HBV的母婴传播主要发生在分娩时，部分是宫内感染，母乳感染并不是主要途径。一些学者发现母血中HBV的含量远高于母乳（包括初乳中病毒的含量），婴儿在宫内或分娩时接触病毒的机率和病毒量也远高于母乳。婴儿如果在宫内或分娩时未感染，通过母乳获得感染的机会更小。同时，人类肠黏膜存在 HBSAg的抑制物，使进入十二指肠的HBSAg失去活性，只有在新生儿或婴儿的消化道粘膜，因炎症导致肠道通透性增加或黏膜直接损伤时，含有 HBV DNA乳汁才可通过黏膜进入血液，引起婴儿感染HBV。同时，随着小儿生长发育成熟，免疫功能日趋完善，此时即使母乳喂养儿接触母乳中的少量病毒，发生慢性感染的可能性也很小。而且目前对感染HBV母亲所生婴儿使用HBIG和乙肝疫苗联合免疫，可阻断大部分分娩时和产后传播。由于母乳中含有多种营养成分和抗病毒物质，经母乳传播HBV的可能性几乎不存在，感染HBV的母亲对新生儿进行母乳喂养仍应提倡。《慢性乙型肝炎防治指南（2010年版）》建议：经过规范的联合免疫后，感染HBV的产妇可以母乳喂养。WHO也提出所有婴儿（母亲HIV感染时除外）都应该母乳喂养，包括对慢性HBV感染母亲的婴儿。当然，不进行母乳喂养，自然感染机率更小。</span></p><p style="clear: both; min-height: 1em; text-indent: 32px; line-height: 21px; background-image: initial; background-position: initial; background-size: initial; background-repeat: initial; background-attachment: initial; background-origin: initial; background-clip: initial; box-sizing: border-box !important;"><span style="color: black; font-family: 宋体, SimSun; box-sizing: border-box !important;"><br></span></p><p style="clear: both; min-height: 1em; text-indent: 32px; line-height: 21px; background-image: initial; background-position: initial; background-size: initial; background-repeat: initial; background-attachment: initial; background-origin: initial; background-clip: initial; box-sizing: border-box !important;"><span style="color: black; font-family: 宋体, SimSun; box-sizing: border-box !important;"><br></span></p></section></section></section></section> <!----></div><!----> 谢谢。 分享这个可以认真看看
感谢分享
这个可以看看 ！长知识了
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