出入境人员丙型肝炎传染性及危险因子研究  

Study on infectious and risk factors of HCV in Entry-exit personnel

作　　者：张培男[1,2] 佟伟军[1] 孙洪生[2] 何龙英[2] 李令保[2] 吴海磊[3] 

机构地区：[1]苏州大学,苏州215123 [2]昆山出入境检验检疫局,昆山215300 [3]南京出入境检验检疫局,南京210001

出　　处：《旅行医学科学》2011年第3期1-5,共5页

摘　　要：目的:为了解出入境人员丙型肝炎(HCV)感染水平,研究HCV感染者的传染性及影响感染的危险因子,提出控制出入境人员丙型肝炎病情发展和降低传染风险的具体措施,保护出入境人员身体健康。方法:用酶联免疫吸附(ELISA)法筛查出入境人员丙型肝炎病毒抗体(抗-HCV),用实时荧光定量PCR法测定150例抗-HCV阳性血清中RNA病毒载量,以性别、年龄((±3)、抗-HCV阴性、HCVRNA阴性、1:4比例为匹配条件,选择600例为阴性对照组,采用SPSS Statistics17.0统计软件中Logistic二元回归模型对抗-HCV阳性组和阴性对照组检测结果进行统计分析。结果:23781名出入境人员传染病监测体检中发现抗-HCV阳性150例,检出率为0.63%,远低于我国普通人群感染水平(3.2%);男女间感染HCV的机率均等(X2=0.506,P>0.05);抗-HCV阳性率随年龄增长而升高,各年龄组间差异显著(X2=86.065,P<0.001);外国籍人群抗-HCV阳性率显著低于中国及港澳台地区人群(X2=12.376,P<0.05);抗-HCV阳性者中78.67%HCVRNA病毒处于复制状态,其中抗-HCV滴度≤1:16人群HCVRNA病毒载量均≤500copy/ml,抗-HCV滴度≥1:64人群HCVRNA病毒载量均≥1.02X104copy/ml,各抗体滴度间HCVRNA病毒载量有显著性差异(X2=136.593,P<0.001);从30个检查检测指标中筛选出性别、年龄、国籍、心率、ALT、GGT、CREA、LDL、HBsAg、HBeAb等10个HCV危险因子,其回归方程为:Y=1.056X4+0.285X5-0.44X6-0.021X11+0.102X13-0.005X15+0.02X21-0.758X27+4.87X28-1.294X31-2.934,经回归模型检验证明二元回归方程拟合程度非常好(回归模型系数的综合检验卡方值为259.795,P<0.001,模型-2对数似然值为490.808c,Cox﹠SnellR方值为0.293,NagelkerkeR方值为0.463)。结论:出入境人员HCV感染者中78.67%具有传染性,抗-HCV滴度≥1:64指标可作为HCV传染性的判断指标;HCV感染的危险因子有性别、年龄、国籍、心率、ALT、GGT、CREA、LDL、HBsAg、HBeAb。Objective： To understand Hepatitis C （HCV） infection levels in entry-exit personnel, Study on infectious and risk factors of HCV infection and provide control specific measures of HCV condition progress and reduce infectious risk, In order to protect health of entry-exit personnel. Methods： Enzyme-linked immunosorbent assay （ELISA） screening for entry-exit personnel by hepatitis c virus antibodies （anti-HCV） and using real-time fluorescent quantitative PCR method for the determination of 150 cases of positive anti-HCV RNA in Sera of viral load. By sex, age （（＋ 3） , anti-HCV negative, HCVRNA negative, 1：4 ratio for the match condition, select 600 cases of negative control group. Using statistical software SPSS Statistics 17.0 Logistic binary regression model anti-HCV positive group and negative control group for statistical analysis of test results. Results： 150 anti-HCV positive were detected from 23781 entry-exit peoples health examination of communicable disease surveillance, detection rate was 0.63 percent, was lower than infection lever of Chinese peoples （3.2%） .Man and women equal chance of HCV infection （X^2=0.506, P〉0.05） . Anti-HCV-positive rate increased with age （X^2=86.065,P〈0.001） . Foreign crowd of anti-HCV positive rate was significantly lower than the regional populations in China and Hong Kong, Macao, Taiwan （X^2= 12.376, P〈0.05） . Anti-HCV positive in 78.67% HCVRNA virus is replication status, Titer ≤1：16 for anti-HCV viral load volume HCVRNA crowd ≤ 500copy/ml, titer ≥ 1：64 for anti-HCV viral load volume HCVRNA crowd ≥1.02 X 104copy/ml, The antibody titers between viral load HCVRNA significant difference （X2=136.593, P〈0.001） . From 30 check index filters out of sex, age, nationality, heart rate, ALT, GGT, CREA, and LDL, HBsAg, HBeAb 10 HCV risk factor. Regression equation： Y= 1.056X4 ＋ 0.285X5 - 0.44X6 - 0.021Xll ＋ 0.102X13 - 0.005X15 ＋ 0.02X21 - 0.758X27 ＋ 4.87X28 - 1.294X31-2.934, Bybinary regression equation-fitt

关 键 词：出入境人员 丙型肝炎 传染性 危险因子 

分 类 号：R512.63[医药卫生—内科学]