水源因素与戊型肝炎病毒感染的关联性  

The relationship between water-associated settings and the prevalence of IgG-class antibodies to hepatitis E virus

作　　者：陆一涵[1] 宋建根[2] 葛胜祥[3] 姜庆五[1] 王法弟[2] 郭清顺[3] 董晓莲[2] 朱连华[2] 范建良[2] 高眉扬[1] 夏宁邵[3] 郑英杰[1] 

机构地区：[1]复旦大学公共卫生学院流行病学教研室-公共卫生安全教育部重点实验室,上海200032 [2]浙江省德清县疾病预防控制中心,德清313200 [3]厦门大学福建省医学分子病毒学研究中心,厦门361005

出　　处：《复旦学报（医学版）》2007年第5期662-668,共7页Fudan University Journal of Medical Sciences

基　　金：复旦大学青年科学基金项目(JKF201001)

摘　　要：目的通过检测浙江省德清县水系上下游地区农村人群血清戊型肝炎病毒抗体水平,以评价非爆发状态下水源因素与戊型肝炎病毒感染的关联性。方法通过统一的调查表收集1 720人的一般资料及可能危险因素,并采用间接酶联免疫吸附法检测血清抗HEV-IgG抗体。结果总标化抗体阳性率为48.79%。其中,上游地区人群标化抗体阳性率为43.52%,下游标化阳性率为51.26%。将两地人群不同的构成特征调整后,下游抗体阳性率仍显著高于上游。同时发现,男性抗体阳性率高于女性;各年龄组阳性率随年龄升高而增加;家庭养猪、喜食猪肝、主要饲养动物和饮酒皆与戊肝感染有统计学关联。结论浙江农村地区戊型肝炎病毒感染情况与当地水源因素有较为显著的关联;猪可能是戊型肝炎病毒的自然宿主之一。Purpose To assess the relationship between water-associated settings and the prevalence of IgG-class antibodies to hepatitis E virus by a cross-sectional study in two rural districts separately located upstream and downstream in Zhejiang province. Methods A total of 1 720 healthy persons with age over 4 years old upstream and downstream along the main local water system was interviewed to evaluate their epidemiological characteristics, including family status and individual features. Anti-HEV IgG antibody in sera collected from the same population was tested with an indirect enzyme-linked immunosorbent assay （ELISA） to determine the seroprevalence of hepatitis E virus. Resdts Total standardized prevalence of the general population was as high as 48.79 %, and it was higher in the downstream （51.26 % ） than in the upstream （43.52 %）. This difference remained after the adjustment of distinct constitutional features according to the comparison of polpulation structure between the sampling populations upstream and downstream. In the multivariate analysis, stepwise logistic regression modeling techniques were applied to identify other risk factors for HEV infection. It was suggested that the prevalence of male was higher than female and the prevalence increased with age significantly. The association between the prevalence of anti-HEV IgG and household swine breeding, pork liver eating, chief animal raising, and alcohol drinking was also significant statistically. Conclusions These findings attest to a unique relationship between environmental conditions, i. e. , waterassociated settings, and epidemic HEV spread among the rural population in Zhejiang. HEV infection was al- so significantly associated with swine and pork.

关 键 词：肝炎病毒 抗戊型肝炎-IgG抗体 经水传播 人畜共患病 

分 类 号：R512.6[医药卫生—内科学]