天津市控制甲型病毒性肝炎的策略效果分析  

Effectiveness analysis of Tianjin hepatitis A control strategy

作　　者：单爱兰[1] 张之伦[1] 吴伟慎[1] 何海艳[1] 李超[1] 赵莹[1] 

机构地区：[1]天津市疾病预防控制中心,天津300011

出　　处：《口岸卫生控制》2012年第4期29-32,共4页Port Health Control

摘　　要：目的明确控制甲型病毒性肝炎(简称:甲肝)的最佳策略。方法根据天津市疾病预防控制中心历年对甲肝监测和研究结果,并结合国内外其他作者的报道,采用描述性流行病学的方法进行综合分析。结果在以切断传播途径为主的综合性控制阶段(1980年-1994年):以1980年-1989年为代表,全人群病毒性肝炎报告发病率波动于76.5～196.1/10万之间,属历史高发阶段,经血清学确认,甲肝为主要类型;若将<20岁病例定为甲肝统计,则甲肝年均病例数占全人群甲肝病例总数的62.50%。以接种甲肝疫苗为主的综合控制阶段(1995年至今):随着甲肝疫苗接种工作的推进,<20岁人群抗-HAV流行率逐渐增高,且具有统计学意义(χ2=43～79,P<0.05),至2010年已达到1998年和2005年20～29岁成人的水平。甲肝报告发病率由1994年的19.60/10万下降至2005年的0.87/10万,下降幅度为95.56%,且已连续7年低于1/10万,打破了天津市以前甲肝在发病年龄、季节和流行高峰年等方面的流行规律。结论切断传播途径是控制甲肝的辅助性措施,规范化接种甲肝疫苗是控制甲肝的最佳策略。Objective To know the best strategy of controlling hepatitis A. Methods Based on the results of mo- nitoring and research of hepatitis A carried out by Tianjin CDC over the years and reports by other authors both at home and abroad, descriptive epidemiological methods are applied to comprehensive analysis. Results During 1980 to 1994, a control phase of cutting off the transmission rout, especially during 1980 to 1989, the incidence rate of hepatitis in whole population were reported between 76.5 to 196.1 out of i million range. It is a phase of the highest rate in history. The main type was hepatitis confirmed by serology. And average annual number of cases un- der 20 years old accounted for 62.50% of the total cases. From 1995 till now, a control phase of Hepatitis A vac- cine, with the advance of hepatitis A vaccination, rate of anti - HAV under 20 years old increased gradually and had statistical significant （X2 = 43 -79, P 〈 0.05 ）. Until 2010, it reached 20 -29 year -old adult level of 1998 and 2005. Incidence rate of hepatitis A has dropped from 19.60 out of 1 million in 1994 to 0.87 out of i million in 2005, with a decrease of 95.56%. And it has been less than lout of 1 million for seven consecutive years, break- ing the previous rules of onset age, peak seasons and peak years in Tianjin. Conclusion Cut off the transmission rout is the supportive control measures for hepatitis A and standardization of hepatitis A vaccination is the best strategy~,

关 键 词：病毒性肝炎 甲型 抗-HAV 流行率 发病率 

分 类 号：R512.6[医药卫生—内科学]