洛阳市不同县区乙型病毒性肝炎报告发病率差异原因探讨  

Discussion on the causes of differences in reported incidences of hepatitis B from different counties in Luoyang

作　　者：李云霞[1] 何旺杰[2] 赵丽敏[3] 

机构地区：[1]河南洛阳洛阳市疾病预防控制中心传染病预防控制所,471023 [2]南阳市疾病预防控制中心 [3]焦作市疾病预防控制中心

出　　处：《国际病毒学杂志》2012年第5期198-201,共4页International Journal of Virology

摘　　要：目的探讨洛阳市不同县区乙肝报告发病率差异的影响因素。方法选择洛阳市乙肝报告发病率相差悬殊的伊川县、洛宁县和嵩县的四家医院。采用问卷调查、个人访谈调查临床医生对乙肝诊断上报标准掌握及应用情况。核查2009—2010年三县乙肝病例的漏报、当年重报和跨年度重报情况。结果三县临床医生对单纯FIBsAg阳性是否上报为乙肝病例、FIBsAg阳性合并肝功能异常是否上报为乙肝病例方面均有差异，且差异均有统计学意义（P〈0．01）。三县被调查临床医牛中应用2008版乙肝诊断标准的占52．04％，仍用1995年老标准的占16．33％，混用1995版和2008版标准的占11．22％。2009年和2010年伊川县乙肝重报率分别为3，08％和2．43％，漏报率分别为1．39％和0．00％，洛宁县两年重报率分别为2．86％和0．00％，漏报率分别为5．56％和54．28％，嵩县重报率分别为1．27％和0，漏报率为30％和20．51％。结论基层医务人员对现有乙肝诊断标准掌握不准确，缺乏统一的乙肝病例上报标准，在疫情管理中存在重报、漏报等现象是造成各地区乙肝报告发病率差异的重要原因。Objective To explore the factors affecting the reported incidences of hepatitis B in different counties in Luoyang. Methods Four hospitals from Yichuan, Luoning and Song county, where reported incidences of hepatitis B were obviously different were investigated. Questionnaire survey and personal interviews were conducted to investigate the acquaintance and application of diagnosis criteria and report criteria of hepatitis B. The missing reports, duplicated reports of hepatitis B eases within one year and two year were checked from 2009 to 2010 in three counties. Results Among clinical doctors from three counties, there were significant differences about whether cases of single positive HBsAg or cases of positive HBsAg combined abnormal liver function should be reported （ P 〈 0. 01 ）. And the proportion of using the diagnostic criteria of 2008 edition, using the criteria of 1995 edition, mixed using both criteria were 52.04%, 16. 33% , 11.22% respectively. The rates of duplicated report were 3.08% and 2. 43% , and the rates of mising report were 1.39% and 5.56% in 2009 and 2010 in Yiehuan county; The rates of duplicated report were 2.86% and 0. 00% , and the rates of raising report were 5.56% and 54. 28% in 2009 and 2010 in luoNing country; The rates of duplicated report were 1.27% and 0. 00%, and the rates of mising report were 30% and 20. 51% in 2009 and 2010in Song county. Conclusions Grass-roots medical staffs were not familiar with the latest diagnostic criteria of hepatitis B, uniformed reporting was missing, and there existed the duplicated reports ,missing report phenomenon in the epidemic management. These were important reasons for the bias in reported incidence among different districts.

关 键 词：乙型病毒性肝炎 报告发病率 诊断标准 重报 漏报 

分 类 号：R181[医药卫生—流行病学] R51[医药卫生—公共卫生与预防医学]