2017年马鞍山市60岁以下人群乙型病毒性肝炎血清流行病学调查

杨锟; 方大春; 秦其荣; 项可霞; 范引光

doi:10.16462/j.cnki.zhjbkz.2019.01.011

2017年马鞍山市60岁以下人群乙型病毒性肝炎血清流行病学调查

doi: 10.16462/j.cnki.zhjbkz.2019.01.011

杨锟^{1, 2},
方大春²,
秦其荣²,
项可霞²,
范引光^1, ,

1.
230032 合肥, 安徽医科大学公共卫生学院流行病与卫生统计学系
2.
243000 马鞍山, 马鞍山市疾病预防控制中心免疫规划科

基金项目:

省级质量工程研究项目 2016jxxm0522

安徽医科大学博士科研资助基金 XJ201526

详细信息

通讯作者:
范引光, E-mail: fanyinguang@163.com

中图分类号: R195;R575.1
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出版历程
- 收稿日期: 2018-07-10
- 修回日期: 2018-09-10
- 刊出日期: 2019-01-10

Seroepidemiological survey of hepatitis B virus infection among people under 60 years old in Ma'anshan City, 2017

1.
Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei 230032, China
2.
Department of Planned Immunization, Ma'anshan Center for Disease Control and Prevention, Maanshan 243000, China

Funds:

Teaching Quality Engineering Project of Anhui province 2016jxxm0522

Anhui Medical University XJ201526

More Information

Corresponding author: FAN Yin-guang, E-mail: fanyinguang@163.com

摘要

摘要: 目的了解马鞍山市现阶段人群乙肝流行和免疫状况，对比乙肝疫苗免疫策略调整后的防控效果。方法采用多阶段单纯随机抽样方法抽取马鞍山市10个调查点，按照城乡分层随机抽取3 460名60岁以下人群样本，开展问卷调查并采集静脉血标本，用国产酶联免疫吸附试验（enzyme linked immunosorbent assay，ELISA）试剂进行检测。结果乙肝病毒表面抗原（hepatitis B virus surface antigen，HBsAg）总阳性率为3.32%，乙肝病毒表面抗体（hepatitis B virus surface antibody，HBsAb）总阳性率为51.21%，乙肝病毒（hepatitis B virus，HBV）总感染率为29.16%。城市人群HBsAb阳性率高于农村（χ²=28.204，P<0.001）。医护人员HBsAb阳性率与其他职业人群间差异有统计学意义（χ²=22.772，P<0.001）。乙肝疫苗（hepatitis B vaccine，HepB）抗原含量调整前后儿童HBsAb阳性率差异有统计学意义（χ²=90.331，P<0.001）。HepB接种率随年龄增长呈下降趋势（χ_趋势²=1 984.342，P<0.001）。结论自乙肝疫苗纳入免疫规划以来，马鞍山市适龄儿童乙肝防控工作取得成绩显著。学生人群HBsAb阳性率较低和成年人HepB接种率低应重点关注。
- 乙肝 /
- 血清流行病学 /
- 疫苗
Abstract: Objective To understand the current epidemic and immunity status of hepatitis B virus in Ma'anshan City, and to compare the prevention and control effect after the adjustment of hepatitis B vaccine immunization strategy. Methods Multi-stage random sampling method was used to select 10 investigation points in the whole city, a random sample of 3 460 people under 60 years old was included according to urban and rural stratification. questionnaires and blood were collected from the subjects, and domestic enzyme linked immunosorbent assay (ELISA) was used for hepatitis B immunoglobulins detection. Results The total positive rate of hepatitis B virus surface antigen (HBsAg), hepatitis B virus surface antibody (HBsAb) and Hepatitis B virus (HBV) infection was 3.32%, 51.21% and 29.16% respectively. The positive rate of HBsAb in urban area was higher than that in rural area (χ²=28.204, P<0.001). The positive rate of HBsAb was significantly different between the medical and nursing staff and other occupational groups (χ²=22.772, P<0.001). The difference of HBsAb positive rate before and after HepB vaccine content adjustment was statistically significant (χ²=90.331, P<0.001). The rate of HepB decreased with age (χ_trend²=1 984.342, P<0.001). Conclusions Since HepB was incorporated into the immunization program, hepatitis B prevention and control in school-age children has achieved remarkable results. More attention should be paid on the low positive rate of HBsAb in students and the low immunization rate of HepB in adults.
- Hepatitis B /
- Seroepidemiology /
- Vaccine

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图 1 HBV感染标志物年龄别分布

Figure 1. The age distribution of infection rate of HBV

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表 1 不同年龄、性别、地区和职业人群HBV感染情况[n(%)]

Table 1. Comparison of infection rate of HBV by different age, gender, region and occupation [n(%)]

项目	调查人数(构成比)	HBsAg阳性数(阳性率)	HBsAb阳性数(阳性率)	HBcAb阳性数(阳性率)	HBV感染数(感染率)
年龄(岁)
1~	1 301(37.60)	2(0.15)	615(47.27)	21(1.61)	22(1.69)
15~59	2 159(62.40)	113(5.23)	1 157(53.59)	495(22.93)	987(45.72)
χ²值		65.203	12.971	290.612	761.662
P值		＜0.001	＜0.001	＜0.001	＜0.001
性别
男	1 539(44.48)	45(2.92)	791(51.40)	198(12.87)	408(26.51)
女	1 921(55.52)	70(3.64)	981(51.07)	318(16.55)	601(31.29)
χ²值		1.378	0.037	9.161	9.431
P值		0.240	0.847	0.002	0.002
地区
城市	1 724(49.83)	46(2.67)	961(55.74)	226(13.11)	497(28.83)
农村	1 736(50.17)	69(3.97)	811(46.72)	290(16.71)	512(29.49)
χ²值		4.595	28.204	8.815	0.185
P值		0.032	＜0.001	0.003	0.667
职业
医护人员	117(5.80)	2(1.71)	88(75.21)	18(15.38)	42(35.90)
其他职业人群	1 899(94.20)	110(5.79)	998(52.55)	469(24.70)	934(49.18)
χ²值		3.502	22.772	5.217	7.790
P值		0.061	＜0.001	0.022	0.005

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表 2 不同职业人群HepB接种和HBV感染情况[n(%)]

Table 2. The rate of HepB vaccination and HBV infection in different occupation [n(%)]

职业	调查人数(构成比)	HepB接种数(接种率)	HBsAg阳性数(阳性率)	HBsAb阳性数(阳性率)	HBV感染数(感染率)
学龄前儿童	482(13.93)	482(100.00)	1(0.21)	298(61.83)	3(0.62)
农民	616(17.80)	80(12.99)	40(6.49)	289(46.92)	333(54.06)
工人	317(9.16)	84(26.50)	17(5.36)	168(53.00)	146(46.06)
干部/职员	139(4.02)	61(43.88)	9(6.47)	85(61.15)	60(43.17)
学生	962(27.80)	939(97.61)	2(0.21)	388(40.37)	30(3.12)
教师	40(1.16)	21(52.50)	1(2.50)	20(50.00)	11(27.50)
医护人员	117(3.38)	70(59.83)	2(1.71)	88(75.21)	42(35.90)
服务人员	134(3.87)	36(26.87)	8(5.97)	69(51.49)	55(41.04)
个体	275(7.95)	70(25.45)	11(4.00)	163(59.27)	139(50.55)
待业	94(2.72)	29(30.85)	6(6.38)	52(55.32)	43(45.74)
其他职业	284(8.21)	64(22.54)	18(6.32)	152(53.33)	147(51.76)
合计	3 460(100.00)	1 936(55.95)	115(3.32)	1 772(51.21)	1 009(29.16)

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表 3 不同免疫史以及不同时间节点出生人群HBV感染情况[n(%)]

Table 3. The infection rate of HBV in different immune history and time points of birth [n(%)]

项目	调查人数(构成比)	HBsAg阳性数(阳性率)	HBsAb阳性数(阳性率)	HBcAb阳性数(阳性率)	HBV感染数(感染率)
免疫史
有	1 936(55.95)	16(0.83)	1 059(54.70)	119(6.15)	119(6.15)
无	577(16.68)	48(8.32)	261(45.23)	174(30.16)	342(59.27)
不详	947(27.37)	51(5.39)	452(47.73)	223(23.55)	548(57.87)
χ²值		94.908	22.278	278.547	1 127.390
P值		＜0.001	＜0.001	＜0.001	＜0.001
HepB免疫策略调整
1992年以前出生	1 782(51.50)	110(6.17)	961(53.93)	462(25.93)	942(52.86)
1992-2001年出生	347(10.03)	3(0.86)	181(52.16)	33(9.51)	44(12.68)
2001年以后出生	1 331(38.47)	2(0.15)	630(47.33)	21(1.58)	23(1.73)
χ²值		93.265	13.403	364.836	1 015.084
P值		＜0.001	0.001	＜0.001	＜0.001
HepB抗原含量调整
2002-2012年出生	1 010(75.88)	1(0.10)	404(40.00)	21(2.08)	22(2.18)
2012年以后出生	321(24.12)	1(0.31)	226(70.40)	0(0)	1(0.31)
χ²值		-	90.331	6.781	4.998
P值		0.424	＜0.001	0.009	0.025

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