社区人群乙肝疫苗接种前最优筛检方案  

Best Screening Programme of Hepatitis B Vaccination Among Community Population

作　　者：张巧利[1] 单金华 夏宪照[1] 袁钦发 王水能[1] 

机构地区：[1]广东省东莞市疾病预防控制中心,东莞523016 [2]广东省东莞市常平医院

出　　处：《预防医学情报杂志》2005年第1期30-32,共3页Journal of Preventive Medicine Information

摘　　要：目的　确定东莞市社区人群乙肝疫苗接种前最优筛检方案。方法　以随机整群抽样的方法抽取东莞市某一社区的所有居民共 32 90人作为研究对象 ,进行乙肝 3项指标的检测。以该人群乙肝病毒标志物阳性率为基本参数 ,采用费用 -效果分析法和决策树法确定社区人群乙肝疫苗接种前的最优筛检方案 ;采用灵敏度分析法和阈值分析法探讨引入模型的参数对方案优化的贡献及需检验参数的阳性率阈值。结果　东莞市社区人群乙肝疫苗接种前最优筛检方案为仅单测抗 -HBs;HBsAg、抗-HBs、抗 -HBc检测的阳性率阈值分别为 0 4 0、 0 4 0、 0 4 0。结论　社区人群乙肝疫苗接种前可只检测抗 -HBs,这与同时检测乙肝 3项指标的预防效果相同 ,但却显著节省费用。Objective To confirm the best screening programme of hepatitis B vaccination among community population of Dongguan city. Method All the residents of a community, 3290 in total, were chosen to be studied by random cluster sampling and their hepatitis B virus markers were detected. The best screening programme of hepatitis B vaccination among community population was confirmed by cost-effect analysis and decision tree model. Sensitivity analysis was used to study the effects of screening programme by different costs of vaccine and screening tests. The thresholds of positive rates of the parameters introduced in model were evaluated by threshold analysis. Result The most effective screening programme of hepatitis B vaccination among community population of Dongguan city was to test hepatitis B surface antibody only. The thresholds of positive rates of testing hepatitis B surface antigen, hepatitis B surface antibody and hepatitis B core antibody were 0.40, 0.40 and 0.40,respectively. Conclusion The most effective screening programme of hepatitis B vaccination among community population is to test hepatitis B surface antibody only. It has the same preventive effect as testing hepatitis B surface antigen, hepatitis B surface antibody and hepatitis B core antibody and it is cost-effective.

关 键 词：乙型病毒性肝炎 费用一效果分析 决策树 免疫策略 

分 类 号：R512.62[医药卫生—内科学]