江苏省2010年和2020年乙型肝炎血清流行病学特征分析

姜洁; 钱姣; 朱立国; 姚敏芳; 朱涛; 徐建芳; 曹民权; 彭红; 朱凤才; 翟祥军

doi:10.16462/j.cnki.zhjbkz.2023.02.018

江苏省2010年和2020年乙型肝炎血清流行病学特征分析

doi: 10.16462/j.cnki.zhjbkz.2023.02.018

姜洁¹,
钱姣¹,
朱立国¹,
姚敏芳²,
朱涛³,
徐建芳³,
曹民权⁴,
彭红¹,
朱凤才¹,
翟祥军^{1, 5, ,}

1.
210009 南京，江苏省疾病预防控制中心重大项目办公室
2.
215600 张家港，张家港市疾病预防控制中心主任室
3.
212310 丹阳，丹阳市疾病预防控制中心主任室
4.
225400 泰兴，泰兴市疾病预防控制中心重大项目办公室
5.
210009 南京，江苏省疾病预防控制中心肠道病原微生物重点实验室

姜洁和钱姣同为第一作者

基金项目:

国家科技重大专项 2018ZX10715-002

详细信息

通讯作者:
翟祥军，E-mail: jszxj@jscdc.cn

中图分类号: R183.9
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- 被引次数: 0
出版历程
- 收稿日期: 2021-12-21
- 修回日期: 2022-05-05
- 网络出版日期: 2023-02-20
- 刊出日期: 2023-02-10

Comparative analysis on seroprevalence of hepatitis B in 2010 and 2020 in Jiangsu Province

1.
Major Project Executive Office, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing 210009, China
2.
Director Office, Zhangjiagang County Center for Disease Control and Prevention, Zhangjiagang 215600, China
3.
Director Office, Danyang County Center for Disease Control and Prevention, Danyang 212310, China
4.
Major Project Executive Office, Taixing County Center for Disease Control and Prevention, Taixing 225400, China
5.
Key Laboratory of Intestinal Pathogenic Microbiology, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing 210009, China

JIANG Jie and QIAN Jiao contributed equally to this article

Funds:

National Major Science and Technology Projects 2018ZX10715-002

More Information

Corresponding author: ZHAI Xiang-jun, E-mail: jszxj@jscdc.cn

摘要

摘要: 目的掌握江苏省社区人群乙型肝炎(简称乙肝)流行变化特征，评价江苏省乙肝综合防控措施的效果。方法采用横断面调查方法，于2010年和2020年在张家港市、丹阳市和泰兴市分别开展了两次大规模乙肝血清流行病学调查。结果 2010年和2020年分别调查了148 196人和100 989人，2020年的HBsAg标化阳性率为5.33%，较2010年7.46%的水平下降了28.55%，张家港市、丹阳市、泰兴市三个示范区2020年的HBsAg标化阳性率分别为2.92%、5.25%和7.14%，较2010年的HBsAg水平均下降。按照不同年龄组比较，2020年较2010年的HBsAg阳性率在各年龄组均存在不同程度的降低，尤其在20~＜35岁年龄组出现大幅度的降低。在2020年的调查中，明确有乙型肝炎疫苗(简称乙肝疫苗)接种史人群的HBsAg阳性率为4.88%，低于未接种乙肝疫苗人群8.16%的HBsAg阳性率(P＜0.001)。2020年调查中抗-HBs总体阳性率为45.55%，1~＜5岁的婴幼儿抗-HBs阳性率最高，而5~＜20岁的青少年则呈现明显下降的趋势。结论通过乙肝综合防控策略的实施，江苏省传染病示范区的乙肝防控取得了显著成效，但成人乙肝疫苗接种仍需加强。
- 乙型肝炎 /
- 血清学调查 /
- 免疫策略 /
- 乙型肝炎疫苗
Abstract: Objective To describe the characteristics of epidemic change of hepatitis B and to analyze the effect of comprehensive prevention and control measures for hepatitis B in Jiangsu Province. Methods According to the method of a cross-sectional survey, two large-scale seroepidemiological surveys of hepatitis B were carried out in 2010 and 2020 in Zhangjiagang City, Danyang City and Taixing City. Results A total of 148 196 and 100 989 people were investigated in 2010 and 2020, respectively. Age-standardHBsAgprevalence was 7.36% in 2010 and 5.33% in 2020, with a decrease by 28.55%. The HBsAg standard positive rates in Zhangjiagang City, Danyang City and Taixing City demonstration areas in 2020 were 2.92%, 5.25% and 7.14%, respectively, which were significantly lower than the HBsAg levels in 2010. According to the comparison of different age groups, the HBsAg positive rate decreased from 2020 to 2010 in all age groups, especially in the 20-35 age group. In the 2020 survey, the HBsAg positive rate was 4.88% in the population with a history of hepatitis B vaccination, which was significantly lower than that in the unvaccinated population (P < 0.001). The overall positive rate of anti-HBs was 45.55% in the 2020 survey, which was highest in infants aged 1- < 5 years, and decreased significantly in adolescents aged 5- < 20 years. Conclusion Through the implementation of the comprehensive prevention and control strategy for hepatitis B, the prevention and control of hepatitis B in the Jiangsu Province has achieved remarkable results, but the adult hepatitis B vaccination still needs to be strengthened.
- Hepatitis B /
- Serological survey /
- Immunization strategy /
- Hepatitis B vaccine

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图 1 2010年与2020年HBsAg年龄别阳性率的比较

Figure 1. Comparison of age-sepcific positive rates of HBsAg between 2010 and 2020

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表 1 2010年和2020年两次乙肝流行病学调查的人群基本特征[n(%)]

Table 1. Population characteristics of two hepatitis B epidemiological surveys in 2010 and 2020 [n(%)]

变量	2010年	2020年	χ²/T值	P值
地区			506.393 ^a	＜0.001
张家港市	48 422(32.46)	28 515(28.24)
丹阳市	43 565(29.20)	31 602(31.29)
泰兴市	57 199(38.34)	40 872(40.47)
性别			157.001 ^a	＜0.001
男性	67 433(45.20)	43 087(42.67)
女性	81 753(54.80)	57 902(57.33)
年龄(岁)			6 856 633 502 ^b	＜0.001
＜15	17 744(11.89)	13 152(13.02)
15~＜30	23 904(16.02)	11 096(10.99)
30~＜45	36 657(24.57)	19 620(19.43)
45~＜60	39 424(26.43)	29 479(29.19)
≥60	31 457(21.09)	27 642(27.37)
乙肝疫苗接种史			3 625.087 ^a	＜0.001
有	75 945(50.91)	58 852(58.28)
无	50 383(33.77)	22 914(22.69)
不详	22 858(15.32)	19 223(19.03)
合计	149 186(100.00)	100 989(100.00)
注：^a χ²检验；^b Wilcoxon秩和检验。

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表 2 2010年和2020年HBsAg阳性率地区分布的比较

Table 2. Comparison of regional distribution of HBsAg positive rate between 2010 and 2020

地区	2010年			2020年			χ²值	P^b值
地区	阳性数	粗阳性率	标化阳性率^a	阳性数	粗阳性率	标化阳性率^a	χ²值	P^b值
张家港市	2 475	5.11	4.74	930	3.26	2.92	145.191	＜0.001
丹阳市	3 413	7.83	7.13	1 891	5.98	5.25	95.540	＜0.001
泰兴市	5 591	9.77	10.36	3 130	7.66	7.14	131.816	＜0.001
合计	11 479	7.69	7.46	5 951	5.89	5.33	301.512	＜0.001
注：^a按照全国人口年龄构成进行标化；^b两组间HBsAg粗阳性率的比较。

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表 3 2020年乙肝调查中乙肝疫苗接种史与HBsAg阳性率的关系

Table 3. Association between hepatitis B vaccination history and HBsAg positive rate in the 2020 hepatitis B survey

年龄(岁)	接种组(N=58 852)		未接种组(N=22 912)		χ²值	P值
年龄(岁)	检测人数	HBsAg阳性数	检测人数	HBsAg阳性数	χ²值	P值
1~＜30 ^a	22 557	292(1.29%)	1 666	40(2.40%)	14.05	＜0.001
≥30 ^a	36 295	2 578(7.10%)	21 246	1 830(8.61%)	43.224	＜0.001
合计	58 852	2 870(4.88%)	22 912	1 870(8.16%)	325.881	＜0.001
注：^a 1~＜30岁、≥30岁年龄组中分别有25人、19 198人乙肝疫苗接种史不详。

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表 4 2020年调查中抗-HBs阳性率的年龄分布情况

Table 4. Age distribution of anti-HBs positive rate in the 2020HBsAg survey

年龄(岁)	张家港市			丹阳市			泰兴市			合计
年龄(岁)	检测人数(N)	阳性数(N)	阳性率(%)	检测人数(N)	阳性数(N)	阳性率(%)	检测人数(N)	阳性数(N)	阳性率(%)	检测人数(N)	阳性数(N)	阳性率(%)
1~＜5	398	226	56.78	9	7	77.78	61	45	73.77	468	278	59.40
5~＜10	1 268	225	17.74	1 828	299	16.36	3 005	688	22.90	6 101	1 212	19.87
10~＜15	1 161	172	14.81	2 850	339	11.89	2 572	413	16.06	6 583	924	14.04
15~＜20	1 293	228	17.63	392	83	21.17	560	252	45.00	2 245	563	25.08
20~＜25	1 020	361	35.39	720	295	40.97	1 686	940	55.75	3 426	1 596	46.58
25~＜30	1 170	438	37.44	1 489	729	48.96	2 765	1 300	47.02	5 424	2 467	45.48
30~＜35	2 146	973	45.34	2 620	1 145	43.70	3 054	1 475	48.30	7 820	3 593	45.95
35~＜40	1 871	866	46.29	2 140	962	44.95	2 166	1 091	50.37	6 177	2 919	47.26
40~＜45	1 589	736	46.32	1 731	799	46.16	2 303	1 228	53.32	5 623	2 763	49.14
45~＜50	1 796	896	49.89	2 185	975	44.62	3 962	2 222	56.08	7 943	4 093	51.53
50~＜55	2 964	1 508	50.88	3 195	1 438	45.01	5 147	2 940	57.12	11 306	5 886	52.06
55~＜60	3 226	1 676	51.95	3 637	1 621	44.57	3 365	1 896	56.34	10 228	5 193	50.77
≥60	8 612	4 592	53.32	8 803	3 973	45.13	10 226	5 949	58.18	27 641	14 514	52.51
合计	28 514	12 897	45.23	31 599	12 665	40.08	40 872	20 439	50.01	100 985	46 001	45.55

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