住院患者HBV血清标志物筛查70 582例结果回顾性分析  

Retrospective analysis of hepatitis B virus serological markers in 70 582 inpatients

作　　者：叶波[1] 杨大干[1] 郑书发[1] 李雪芬[1] 陈瑜[1] 

机构地区：[1]浙江大学医学院附属第一医院检验中心浙江大学传染病诊治国家重点实验室,杭州310003

出　　处：《中华检验医学杂志》2010年第10期918-923,共6页Chinese Journal of Laboratory Medicine

基　　金：国家十一五“艾滋病和病毒性肝炎等重大传染病防治”科技重大专项课题资助（2008ZX10002-012）

摘　　要：目的分析近6年来HBV血清标志物检出率变化情况.方法收集3家大型医院2003-2008年6年间排除肝炎及相关病区共70 582例住院患者.采用AxSYM微粒子酶免疫分析技术检测HBV血清标志物5项,包括HBsAg、HBeAg、抗-HBc、抗-HBe和抗-HBs结果及相关资料,并将每例5项标志物结果作为一种模式,对各项标志物及模式检出率逐年变化情况进行回顾性分析.结果 HBV血清标志物5项检出率由高到低依次为抗-HBc（55.17%）、抗-HBs（49.57%）、抗-HBe（28.42%）、HBsAg（8.92%）、HBeAg（2.12%）,且6年来均呈逐渐下降趋势.HBsAg由2003年的9.30%降至2008年8.70%,1992年以后出生人群HBsAg检出率（2.28%）明显低于总人群检出率（8.92%）,且逐年下降趋势明显,从2003年的3.57%降至2008年1.85%.每项标志物检出率男性（HBsAg、HBeAg、抗-HBc、抗-HBe和抗-HBs检出率依次为12.38%、2.72%、56.57%、41.50%、65.48%）均高于女性（HBsAg、HBeAg、抗-HBc、抗-HBe和抗-HBs检出率依次为7.25%、1.58%、53.43%、28.35%、50.00%）,差异有统计学意义（x2值分别为509.74、105.78、69.66、1 321.61、1 726.91,P均＜0.01）.在70 582例患者中,5项HBV血清标志物结果可归纳为26种模式,检出率≥1%的模式有8种,＂全阴性＂模式占第一位,6年间无明显变化.近6年来,人群不同年龄段不同检测模式检测结果不同,≤20岁人群以＂全阴性＂和＂抗-HBs单独阳性＂模式为主,＞20岁人群以＂抗-HBc和（或）抗-HBe、抗-HBs阳性＂等模式为主.＂HBsAg、HBeAg、抗-HBc阳性＂和＂HBsAg、抗-HBc、抗-HBe阳性＂等模式检出率呈两端低、中间高分布,20～70岁人群检出率高.结论近6年HBV血清标志物检出率呈缓慢下降趋势,低龄人群HBsAg检出率明显下降.总人群HBV感染率依然较高,不断改进HBV血清筛查技术对于降低HBV感染率十分重要.Objective To analyze the detection rate of HBV serological makers in non-hepatic inpatients in the past six years. Methods Serum samples of 70 582 non-hepatic inpatients from three large hospitals were collected during 2003 to 2008. Serological markers of HBV （ HBsAg, anti-HBs, HBeAg, antiHBe and anti-HBc） were detected by the AxSYM MEIA system （Abbott Laboratories,Abbott Park,IL）.Combining the test results of serological makers with other clinical data, several analysis models for this retrospective study were set up to evaluate the year-to-year changes in serological makers and the detection rates of each model. Results The order from high to low of detection rate of the 5 HBV serological markers was anti-HBc （55. 17% ）, anti-HBs （49. 57% ）, anti-HBe （28.42%）, HBsAg （ 8. 92% ） and HBeAg （2. 12% ）, and all of them had a downward trend in the past six years. The positive rate of HBsAg went down from 9. 30% （2003） to 8.70% （2008）. The positive rate of HBsAg among people who were born after 1992 （2. 28% ） were significantly lower than that of the overall population （8. 92% ） and fell from 3.57%（2003） to 1.85% （2008）. Each detection rate of all serological makers had male sexual side effect [HBsAg （ 12. 38%/7. 25% ）, HBeAg （ 2. 72%/1.58% ）, anti-HBc （ 56. 57%/53.43% ）, anti-HBe （41.50%/28. 35% ） and anti-HBs （65.48%/50. 00% ）, male/female]. The differences were statistically significant （Chi-square values of HBsAg, HBeAg, anti-HBc, anti-HBe and anti-HBs were 509.74,105.78, 69.66, 1 321.61 and 1 726.91, respectively; all P 〈 0. 01）.Twenty-six models of HBV serological makers from 70 582 inpatients were summed up, and 8 models had positive rates geater than or equal to 1%. The ＂All Negative＂ model ranked No. 1 and had no significant change from year to year. During the past six years, models representing ＂A11 Negative＂ and ＂anti-HBs Positive alone＂ were mainly in individuals younger than or equal to 20-year-old, while the models

关 键 词：肝炎病毒 乙型 肝炎抗原 乙型 生物学标记 免疫酶技术 回顾性研究 

分 类 号：R686[医药卫生—骨科学]