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 among 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]苏州大学公共卫生学院,江苏苏州215123 [2]昆山出入境检验检疫局 [3]南京出入境检验检疫局

出　　处：《中国国境卫生检疫杂志》2012年第3期168-171,193,共5页Chinese Journal of Frontier Health and Quarantine

基　　金：江苏检验检疫局科研基金项目(2009JK38)

摘　　要：目的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。方法采用酶联免疫吸附试验(ELISA)筛查出入境人员抗-HCV,并对150份抗-HCV阳性血清采用实时荧光定量PCR法测定HCV RNA病毒载量,以性别、年龄、抗-HCV阴性、HCV RNA阴性、1∶4比例为匹配条件,选择600例为阴性对照组。采用单因素和多因素非条件Logistic回归分析。结果23781名出入境人员传染病监测体检中,检出抗-HCV阳性150例,检出率为0.63%。男女间感染HCV的几率均等;抗-HCV阳性率随年龄增长而升高,各年龄组间差异有统计学意义(χ2=86.065,P<0.001);外籍人员抗-HCV阳性率显著低于中国籍,两者差异有统计学意义(χ2=12.376,P<0.005);78.67%抗-HCV阳性者HCV RNA病毒处于复制状态,抗-HCV滴度≥1∶64感染者HCV RNA病毒载量均≥1.02×104copy/ml,各抗体滴度间病毒载量有显著性差异(χ2=136.593,P<0.001);经单因素回归分析发现,年龄、国籍、谷丙转氨酶(ALT)、天门冬氨酸转氨酶(AST)、直接胆红素(DBIL)、尿素(BUN)、总胆固醇(CHOL)、低密度脂蛋白(LDL)等8个因子均有统计学意义,对这8个因子进行多因素Logistic逐步回归分析,年龄、ALT、LDL等3个因子进入模型。结论78.67%出入境人员HCV感染者具有传染性,抗-HCV滴度≥1∶64指标可作为HCV具有传染性的判断指标;影响HCV感染的危险因子有年龄、国籍、ALT、AST、DBIL、BUN、CHOL、LDL等8个。Objective To analysis the level of hepatitis C （HCV）infection and the infectivity and risk factors of HCV infection among entry-exit people. Methods Enzyme-linked immunosorbent assay （ELISA） screening was used for testing hepatitis C virus antibodies （anti-HCV） among entry-exit people. Real-time fluorescent quantitative PCR method was used for the determination of 150 cases of positive anti-HCV RNA in Sera of viral load. 1：4 matched case-control study was conducted. The objective with same sex, age, anti-HCV negative, HCV RNA negative were recruited as matched controls. Single-factor and muhifactor non-conditional Logistic regression was conducted to analysis the differences between the anti-HCV positive group and negative control group. Results A total of 150 anti-HCV positive were found among 23 781 entry-exit people,with positive rate of 0.63%. Man and women had the equal chance of HCV infection. Anti-HCV-positive rate increased with age （x2 = 86.065, P 〈 0.001）. Anti-HCV positive rate of foreign crowd was significantly lower than populations in China（x2 = 12.376, P〈 0.005）. HCV RNA virus was in replication status among 78.67% Anti-HCV-positive people. Viral load of HCV RNA was ≥ 1.02 × 10^4 copy/ml among those people with anti-HCV titer ≥ 1： 64. Viral load of HCV RNA was significant difference among people with various levels of antibody titers（x2 = 136.593, P 〈 0.001）. Single-factor non-conditional Logistic regression analysis showed 8 risk factors including the age, nationality, ALT, AST, DBIL, BU, CHOL and LDL had significantly statistical difference. The risk factors were taken into muhifactor non-conditional Logistic stepwise regression model. In which, 3 risk factors had significantly statistical difference. Conclusion 78.67% anti-HCV positive of entry-exit people have infectious. Anti-HCV titer ≥1：64 can be regard as the judgment index for HCV infection. The age,nationality, ALT, AST, DBIL, BU, CHOL and LDL were the risk factors of HCV.

关 键 词：出入境人员 丙型肝炎 传染性 危险因子 

分 类 号：R155.5[医药卫生—营养与食品卫生学]