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HEMODİYALİZ HASTALARINDA DEĞİŞİK İKİ DOZ REKOMBİNANT HEPATİT B AŞISI UYGULAMASININ KARŞILAŞTIRILMASI

IMMUNE RESPONSE TO DIFFERENT DOSE RECOMBINANT HEPATITIS B VACCINE IN HEMODIALYSIS PATIENTS

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Abstract (2. Language): 
Hepatitis B vaccine is recommended different do¬sage and different way from the allot of study in he-modialysis patients. We aim to investigate the effect of single and double dose hepatitis B vaccine in hemodi-alysis patients. In this study there was 56 HD patients. Patients were divided into groups. There was 36 pati¬ents in the first and 20 patients in the second group. Patients were dialysed twice or three times weekly 4 hours with poly-sulphane membrane. 20 /ıgr dose of vaccine at 0, 1 and 6th months were given intramuscularly (IM) in the first group. 40 mgr dose of vaccine at the same time and route in the second group. Anti-HBs levels were measured before dialysis at 1,2 and 7 th months. Anti-HBs 10 > WI ml was accepted as a protective level using for hepatitis B virus infection. The data were analysed the APPS computer statistic programme with chi-square test, Student's t test. The level of anti-HBs was greater than 10 IU/ml 69 percent in first group, 85 percent in the second group at end of the seventh month. In the second group level of antiHBs was higher than the first group and was sig¬nificant statistically (p<0.05). In conclusion, we that recommended double dose hepatitis B vaccine in he-modialysis patients.
Abstract (Original Language): 
Bir çok çalışmada hemodiyaliz hastalarında hepa-tit B profitaksisinde değişik doz ve değişik aşılama programları önerilmektedir. Bu araştırmada hemodi¬yaliz hastalarında çift ve tek doz rekombinant hepatit B aşısının antikor cevaplarını karşılaştırdık. Araş¬tırmaya Selçuk Üniversitesi Tıp Fakültesi ve Konya Devlet Hastanesinde düzenli olarak diyalize giren 56 hasta dahil edildi. Birinci grupta 36 hasta, ikinci grupta 20 hasta vardı. Hastalar haftada 2 veya 3 kez düzenli olarak diyalize 4 saat süre ile polisulfon membranlı diyalize giriyorlardı. Birinci gruptaki has¬talara 20 /ıg recombinant hepatitis B aşısı (Gen-He-vac B, Pasteur - Merieux France) 0,1 ve 6'ncı aylarda intramuskuler olarak yapıldı. İkinci gruptaki hastala¬ra aynı dönemde 40 mikrogram aşı aynı yolla uygu¬landı. Kan örnekleri 1,2, 7'nci aylarda diyaliz öncesi alındı. Anti HBs seviyeleri ELISA yöntemi ile ölçüldü. lOUlml'nin üzeri koruyucu olarak kabul edildi. Sonuç¬lar APPS bilgisayar istatistik programında Chi-squa¬re ve Student's t testi ile değerlendirildi. 7'nci ayın so¬nunda birinci gruptaki hastaların % 69'unda, ikinci gruptaki hastaların % 85'inde anti-HBs düzeyi koru¬yucu düzeyi olan 10 Ulml'nin üzerinde idi. Çift doz aşı uygulanan hastalarda koruyuculuk oranı daha yüksek olup iki grup arasındaki fark istatistiki olarak anlamlı idi (p<0.05). Hemodiyaliz hastalarında tek doz aşı uygulaması yerine çift doz aşı yapılmasının daha uygun olacağı kanaatindeyiz.
FULL TEXT (PDF): 
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