摘要:
目的 了解广西壮族自治区16岁以上中学生丙型肝炎病毒（hepatitis C virus，HCV）感染状况及其相关影响因素，为丙型肝炎的预防控制提供科学的理论依据。方法 采用分层整群随机抽样的方法，按地理分布从广西的玉林、南宁、百色、桂林、柳州五个地区抽取2 632名16岁以上高中生，抽静脉血5 ml，采用酶联免疫吸附测定（enzyme-linked immune absorbent assay，ELISA）方法检测抗-HCV，用描述流行病学方法研究丙肝病毒感染的流行特征，用单因素和多因素Logistic回归分析丙肝感染的相关因素。结果 2 632例样本的HCV抗体阳性率为0.84%，男生抗-HCV阳性率为0.73%（6/823），女生阳性率为0.89%（16/1 800），东部（玉林）为1.03%（9/877），西部（百色）为0.66%（3/457），中部（柳州）为1.28% （3/234），北部（桂林）为0.79%（4/509），南部（南宁）为0.54%（3/555），性别和地区差异均无统计学意义（均有P>0.05）。单因素及多因素分析结果显示，公用牙刷史和有内窥镜检查是丙肝感染的高危因素（OR=3.078，95% CI：1.174~48.074，P=0.022；OR=4.182，95% CI：1.328~13.170，P=0.015）。结论 广西高中生丙肝病毒感染是一个重要的公共卫生问题，学生要提高自我保护意识，拒绝共用牙刷，医疗机构要加强医疗器械的消毒，积极开展预防丙型肝炎病毒感染宣传教育，防止医源性传播。
Abstract:
Objective To understand the status of hepatitis C virus (HCV) infection and its related factors among high school students aged over 16 years in the Guangxi Zhuang Autonomous Region, and to provide scientific theoretical basis for the prevention and control of hepatitis C. Methods By using stratified random sampling method, 2 632 high school students aged over 16 years from Yulin, Nanning, Baise, Guilin and Liuzhou were taken 5ml of blood each and anti-HCV were detected by enzyme-linked immune absorbent assay (ELISA). Epidemic characteristics of HCV infection was analyzed by descriptive epidemiological and risk factors were studied by single factor and multi factor Logistic regression. Results The total positive rate of anti-HCV was 0.84% among 2 632 high school students. The anti -HCV positive rates were 0.73% (6/823) for male and 0.89% for female (16/1 800). The prevalence rate of anti-HCV in the eastern(Yulin), western(Baise), middle(Liuzhou), northern(Guilin) and southern(Nanning) areas were 1.03% (9/877), 0.66% (3/457), 1.28%(3/234), 0.79% (4/509) and 0.54%(3/555) respectively. The prevalence rates of anti-HCV for the gender and five areas did not show significant difference(all P>0.05). Single factor and multi factors analysis showed that the common toothbrush (OR=3.078, 95% CI: 1.174-48.074, P=0.022) and history of endoscopy(OR=4.182, 95% CI:1.328-13.170, P=0.015)were high risk factors for HCV. Conclusions HCV infection is an important public health problem among high school students in Guangxi. Students should reinforce self-protect and refuse to share toothbrush with others. It would also be necessary to strengthen the disinfection of medical equipment. At the same time, strengthening health education and health promotion is the effective measure for prevention and control of hepatitis C.
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