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中国乙型肝炎不同流行区最佳免疫策略研究 |
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王璐 李辉 王树声 龚健 曾宪嘉 李荣成 农艺 黄月葵 陈修荣 黄兆能
【摘要】 目的 比较在乙型肝炎不同流行区接种乙型肝炎疫苗的成本效益，探讨最佳免疫策略。方法 采用成本效益分析方法和综合权重评分法，筛选高中低流行区最佳免疫策略。结果 隆安、上海和济南三地接种乙型肝炎疫苗均获明显的经济效益；定义的不同流行区均以低剂量免疫策略(10 μg×3方案)的效益成本比值最大，高、中、低流行区分别为49.91、54.53、37.68；具有较高免疫保护率的高剂量免疫策略可获最大净效益；权重综合评分分析显示，低剂量免疫策略为最佳乙型肝炎免疫策略。结论 建议经济较落后地区实行低剂量免疫策略，期望获得较大效益成本比；经济发达地区实施高剂量免疫策略，以获较大净效益并明显降低人群HBsAg阳性率。
【关键词】 肝炎疫苗，乙型 接种 费用效益分析
Studies on Immunization Strategies for Hepatitis B in Different Endemic Areas of China WANG Lu*, LI Hui, WANG Shusheng, et al. *Department of Epidemiology, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences, School of Basic Medicine, Peking Union Medical College, Beijing 100005
【Abstract】 Objective To compare the cost-benefit of immunization with hepatitis B (HB) vaccine in different endemic areas of HB and to explore the optimal strategy for it. Methods Cost-benefit analysis and comprehensive weighted score analysis (CWSA) were used to screen the optimal immunization strategy for low, medium and heavy endemic areas of HB. Results Significant economic benefit was obtained in Long-An County, Guangxi Zhuang Autonomous Region, Shanghai and Jinan, Shandong Province from HB immunization programs for infants. The greatest benefit cost ratio (BCR) was provided by the low-dose immunization strategy, which was 49.91, 54.53 and 37.68, respectively for heavy, medium and low endemic areas of HB. The maximal net benefit could be obtained by the high-dose immunization strategy with better immune protective efficacy. CWSA showed that the low-dose immunization strategy was the optimal one for HB immunization. Conclusion It is suggested that the low-dose immunization strategy be implemented in undeveloped areas to obtain a greater BCR, and the high-dose one be implemented in more developed areas to obtain more net benefit and lower prevalence of hepatitis B surface antigen carriage.
【Key words】 Hepatitis B vaccines Vaccin[1] [2] 下一页
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