1992年河北城乡居民甲肝流行的随机过程模式研究  

STUDY ON THE STOCHASTIC PROCESS OF HEPATITIS A VIRUS INFECTION IN URBAN AND RURAL POPULATIONS OF HEBEI PROVINCE IN 1992

作　　者：赵玉良 耿建平[2] 朱会宾 刘洪斌 李军 徐德忠[3] 

机构地区：[1]河北省卫生防疫站,保定071000 [2]DepartmentofEpidemiology,NewYorkMedicalCollege [3]第四军医大学流行病学教研室

出　　处：《解放军预防医学杂志》1998年第5期344-349,共6页Journal of Preventive Medicine of Chinese People's Liberation Army

摘　　要：目的 :探讨城乡居民甲肝流行模式 ,为制定免疫预防策略提供依据。方法 :研究对象选择采用多阶段整群系统随机抽样法 ,甲肝抗体检测采用ELISA法 ,资料分析采用随机过程方法—两状态非齐次马尔可夫链 ,首次使用了“年龄组细分法”。结果 :城市人群总体MRR高达 10 9.5 6 ,而农村人群则只有 41.16。MRRts以每 10岁划分年龄组 ,城市人群MRR1 9、MRR1 0 1 9及乡村人群MRR1 9均高于2 0 ;以每 5岁划分年龄组 ,城市人群中 2 0岁以下的 4个年龄组的MRRts均超过 10 ,而农村人群只有 10岁以下的 2个年龄组超过 10 ;以每 2岁划分年龄组 ,城市人群年龄组MRRts绝对值较大 ,正负值交替出现 ,但正值大于 10的年龄组集中在 7～ 16岁之间 ,而农村人群的MRRts值随年龄增大呈下降趋势 ,至 7～ 8岁组已降至 10以下。结论 :城市居民因HAV所承受的的疾病负荷远大于农村居民 ,故应在其高危年龄组 (7～ 16岁 )人群进行有计划的免疫预防 ;农村居民HAV感染的高危年龄为儿童期早期 ,应密切监测甲肝流行趋势 ,以及时发现发病年龄后移和控制可能发生的流行。To determine the epidemiological pattern of hepatitis A virus (HAV) infection in different populations,a Stochastic process method-Two-state non-homogeneous Markov chain was used to analyze the seroprevalence of anti-HAV in urban and rural areas of Hebei province. The total MRR in urban subjects was 109.56, much greater than that in rural subjects(41.16),suggesting that the disease burden was much heavier in urban populations than that in rural compartments. When grouping by 10 years of age, MRR 1 9 , MRR 10 19 in urban subjects and MRR 1 9 in rural subjects were greater than 20. Grouping by 5 years, the MRR ts of the first four age groups in urban subjects and the first two age groups in rural subjects were greater than 10. Grouping by 2 years, the absolute values of MRR ts were big and with an alternative appearance of positive and negative values in urban samples, but the MRR ts above 10 were obviously centralized in 7-16 years of age, showing these people were the high risk group of HAV infection in urban area, and a thoroughly planned vaccination program might be needed. In rural subjects, the MRR ts appeared an obvious tendency of decrease following the increase of age and decreased to less than 10 in age 7-8 years' group, suggesting that most of the infections might pass inapparently and a planned vaccination program might not be needed in rural area.

关 键 词：甲型肝炎 流行病学 随机过程 模式研究 

分 类 号：R512.610.1[医药卫生—内科学]