广西隆安县HBsAg阳性者三年随访研究  

Three-year follow-up study on HBsAg positives in Longan County, Guangxi Province

作　　者：陈钦艳[1] 董柏青[1] 杨进业[1] 韦少超[1] 方孔雄[1] 王学燕[1] 方钟燎[1] 

机构地区：[1]广西壮族自治区疾病预防控制中心,广西南宁530028

出　　处：《中国热带医学》2009年第5期807-809,共3页China Tropical Medicine

基　　金：英国Wellcome基金会资助项目(072058/Z/03/Z);广西科技厅项目(桂科回0731005)

摘　　要：目的探讨HBsAg阳性者原发性肝癌(简称肝癌)发病情况和二级预防作用,为促进HBV感染者进行肝癌早诊早治提供科学依据。方法以分层抽样方法对广西隆安县12个乡镇30～55岁农村居民抽样,采静脉血用(ELISA法检测HBsAg及HBsAg阳性者甲胎蛋白(AFP),选取3007名HBsAg阳性、AFP阴性者进入研究队列,每半年对研究对象进行HBV血清学标志物、谷丙转氨酶(ALT)、AFP检测和肝脏B超检查及肝癌随访,连续三年。结果共随访8826.0人年,肝癌平均发病率为691.14/10万人年,男性高于女性并且随年龄增大而升高。AFP平均阳性率为2.18%,ALT平均异常率为22.80%,其中ALT>100U占20.95%。B超平均异常率为34.67%,以肝内光点增粗为主,占异常人次的35.78%。AFP阳性率及B超异常率随ALT水平升高而增加。AFP和/或B超体检初步诊断肝癌的符合率为88.46%。结论肝癌高危人群HBsAg阳性者,特别是ALT、B超异常且AFP阳性者,加强肝癌的预防及早诊早治,对防治肝癌有重要意义。Objective To explore the situation of primary hver cancer（PLC） in HBsAg positives and value of secondary prevention and provide scientific basis for early detection and treatment of PLC. Methods The subjects were recruited from agricultural workers aged 30-55 years old living in the rural area of all towns in Longan County using stratified sampling. Blood samples were collected tested for HBsAg using ELISA and HBsAg positives were tested for alpha-fetoprotein （AFP） using ELISA. There 3007 positives for HBsAg but negative for AFP. were tested with ultrasound （US） B and their sera were tested for detection of alaninetransaminase （ALT） and AFP every 6 months for three years. Results The total follow-up person-years （PY） were 8826.0.The total incidence rate of PLC was 691.14 per 100 000 PY. The incidence rate of PLC of male was higher than female and rose along with the increase of age. The positive rate of AFP was 2.18%. The abnormal rate of ALT and US were 22.80% and 34.67%. Most abnormality in US was increased spot in liver, accounted for 35.78%.AFP positive rate and US abnormal rate increased with the rise of ALT level . The coincidence rate of AFP and/or US in diagnosis of PLC was 88.46%. Conclusions It is of important significance to ealy diagnose and treat PLC in the HBsAg positives, sespecially those with abnormal ALT and US and positives for AFP.

关 键 词：HBSAG阳性者 随访 筛查 原发性肝癌 

分 类 号：R512.6[医药卫生—内科学]