莆田市某村庄丙型肝炎高发流行病学调查  

High prevalence of hepatitis C virus infection in a village in Putian

作　　者：林国贤[1,2] 黄庆华[1,2] 刘福星[1,2] 涂海健[1,3] 石爽[4] 陈攸涛[5] 陈秀云[1,2] 王桂芝市 谢志勇[1,3] 林玉英[1,2] 邱荣仙[1,2] 吴智宏[1,2] 

机构地区：[1]莆田学院附属医院,莆田市351100 [2]福建医科大学教学医院感染性疾病科 [3]福建医科大学教学医院检验科 [4]北京大学医学部病原生物学系 [5]福建医科大学附属第一医院肝病中心 [6]福建医科大学教学医院儿科

出　　处：《中华实验和临床感染病杂志（电子版）》2009年第4期28-31,共4页Chinese Journal of Experimental and Clinical Infectious Diseases(Electronic Edition)

基　　金：福建省自然科学基金计划资助项目(C0640006)

摘　　要：目的了解本地丙型肝炎高发村庄人群感染情况。方法选择HCV感染率较高的一个自然村作为调查点,2岁以上人群为主要调查对象,填表并采集血样3～5ml,分离血清置-80℃冰箱中备用,采用ELISA方法初筛抗-HCV,初筛阳性者用Abbott试剂复查,复查阳性者定为感染者;以莆田市中心血站2004～2006年义务献血者抗-HCV筛查阳性率作为对照。部分标本进行HCV基因型测定。结果该自然村2岁以上现居住人口1106人,抽样调查1050人,抽样率94.94%;抽样年龄2～86岁,平均(32.8±19.4)岁,中位年龄33岁。抗-HCV阳性者303例,阳性率28.86%;其中男性117例,阳性率25.27%,女性186例,阳性率31.69%,男女阳性率有显著统计学意差异(χ2=5.191,P<0.05)。抗-HCV阳性者平均年龄(47.6±14.5)岁,与阴性患者间有显著统计学差异(t=18.01,P<0.001)。抗-HCV阳性率随年龄增长而增加,有明显家庭聚集现象。<10岁者抗-HCV阳性率为0.91%,≥10岁者为2.85%,≥20岁者为9.78%,≥30岁者为33.91%,≥40岁者为53.69%,≥50岁者为55.24%,≥60岁者为58.46%,≥70岁者为66.67%,≥80岁者为45.45%。而莆田市2004～2006年义务献血者中抗-HCV阳性率仅0.22%。108例行HCV基因分型,其中1b型96例,2a型12例。结论福建省莆田市部分沿海自然村一般人群存在较高的HCV感染率,以基因1b型为主;抗-HCV阳性率随年龄增长而增加,有明显家庭聚集现象;感染与职业献血、输血、输血制品、静脉滥用药物的关系并不明显,高感染原因有待进一步调查。Objective To study the situation of HCV infection in a local village with high infection rate. Methods A village with high HCV intection rate was chosen as the site of survey. Villagers over 2 years old were selected. Blood specimen of 3-5ml were collected and plasma were isolated and then stored at -80~C. Preliminary anti-HCV screening were screened by ELISA, seropositive patients were confirmed by Abbott reagent. HCV genotype analysis were carried out on part of serum specimens. Results There were altogether 1106 people in the village, 1050 of whom received sampling survey and the sampling rate was 94.94%. Sample ages were from 2 to 86 years old, with the average value as 32.8 -＋ 19.4 years old, and the median was 33 years old. There were 303 positive cases of anti-HCV with the rate of 28.86% , of which 117 male cases with positive rate of 25.27% and 186 female cases with 31.69%. There was an obvious difference in the positive rate between male and female （X2 = 5. 191, P 〈 0.05）. The average age of anti- HCV positive patients was 47.6 ± 14.5 years old, which showed significant difference from negative ones （ t = 18.01, P 〈 0. 001 ）. The positive rate of anti-HCV increased with age and there was family gathering. The positive rate of anti-gcv during persons 〈 10 years old was 0.91%, ≥10 years old was 2.85% , I〉20 years old was 9.78%, ≥30 years old was 33.91%, ≥40 years old was 53.69%, ≥50 years old was 55.24% , i〉60 years old was 58.46% ,≥ 70 years old was 66.67% , ≥ 80 years old was 45.45%. Genotyping were carried out in 108 cases, among which 96 cases were lb type and 12 cases were 2a type. Conclusions In some coastal villages in Putian, HCV had a high mortality, mainly with genotype 1 b and there is an obvious family gathering. Infection has no obvious relationship with professional blood donation, blood transfusion, blood products and intravenous drug abuse. The causes for high infection need further in- vestigation.

关 键 词：丙型肝炎 流行病学调查 基因型 

分 类 号：R512.63[医药卫生—内科学] R595.7[医药卫生—临床医学]