2008～2010年18个乙型病毒性肝炎监测试点县报告病例结果分析  

Analysis on the Hepatitis B Cases Reported by National Notificable Disease Reporting System in 18 Pilot Counties in China from 2008 to 2010

作　　者：王富珍[1] 张国民[1] 郑徽[1] 高培[2] 曹凤瑞[3] 蒋征刚[4] 颜丙玉[5] 范军星[6] 邵晓萍[7] 陈筱纯[8] 张晓曙[9] 龚晓红[1] 缪宁[1] 陈园生[1] 孙校金[1] 梁晓峰[1] 崔富强[1] 

机构地区：[1]中国疾病预防控制中心免疫规划中心,北京100050 [2]北京市疾病预防控制中心,北京100013 [3]吉林省疾病预防控制中心,长春130062 [4]浙江省疾病预防控制中心,杭州310051 [5]山东省疾病预防控制中心,济南250014 [6]河南省疾病预防控制中心,郑州450016 [7]广东省疾病预防控制中心,广州511430 [8]四川省疾病预防控制中心,成都610041 [9]甘肃省疾病预防控制中心,兰州730000

出　　处：《中国疫苗和免疫》2013年第5期439-443,共5页Chinese Journal of Vaccines and Immunization

基　　金：国家科学技术"艾滋病和病毒性肝炎等重大传染病防治"重大专项"我国乙型病毒性肝炎免疫预防策略研究"课题(编号2008ZX10002-001);"乙型病毒性肝炎免疫预防新策略的研究"课题(编号2012ZX10002001)

摘　　要：目的评价中国乙型病毒性肝炎(乙肝)报告系统报告的乙肝发病情况。方法在18个乙肝监测试点县,对法定传染病报告系统(National Notificable Disease Reporting System,NNDRS)报告的乙肝病例开展流行病学调查和血标本采集,对血标本进行乙肝病毒表面抗原[Hepatitis B Virus(HBV)Surface Antigen,HBsAg]、抗乙肝病毒核心抗原抗体(Antibody to HBV Core Antigen,Anti-HBc)免疫球蛋白(Immunoglobulin,Ig)M、抗甲型肝炎病毒抗体(Antibody to Hepatitis A Virus,Anti-HAV)IgM检测。按照《乙肝诊断标准》(WS 299-2008)对病例进行诊断,评价乙肝病例报告的准确性,分析急性乙肝发病水平。结果2008～2010年,18个乙肝监测试点县NNDRS报告的631例急性乙肝中,只有223例复核诊断为急性乙肝,355例为慢性乙肝;报告的4536例慢性乙肝中,406例复核诊断为急性乙肝,3563例为慢性乙肝。报告的乙肝(含急性、慢性、未分类)病例中,9%～15%为急性乙肝,67%～82%为慢性乙肝。急性乙肝发病处于较低水平,估算发病率从2008年的7.34/10万下降至2010年的3.86/10万。结论NNDRS中报告的乙肝病例存在分类诊断错误,报告数据不能反映乙肝真实的发病水平。有必要按照《乙肝诊断标准》(WS 299-2008)规范乙肝病例报告,开展有效的实验室检测,提高乙肝监测质量。Abstract： Objective To evaluate the incidence of hepatitis B reported in national notificable disease reporting system （NNDRS）. Method In 18 surveillance counties of hepatitis B, we made a survey for the cases reported in NNDRS and sampled the blood. Hepatitis B virus （HBV） surface antigen （HBsAg）, antibody tO HBV core antigen （Anti-HBc） immunoglobulin （Ig） M and antibody to hepatitis A virus （Anti-HAV） IgM were tested. We confirmed and classified these cases according to hepatitis B diagnosis criteria （WS 299-2008）. The accuracy of case reporting and the incidence of acute hepatitis B were analyzed. Results From 2008 to 2010, there was classified diagnostic error in the NNDRS reported hepatitis B cases. Among 631cases reported acute hepatitis B, 223 cases confirmed acute and 355 casesconfirmed chronic. Among 4536 cases reported chronic hepatitis B, 406 cases confirmed acute and 3563 cases confirmed chronic hepatitis B. The proportion of acute and chronic case was 9 to 15, 67% to 82% respectively in the all NNDRS reported cases, including acute, chronic and unclassified hepatitis B. The incidence of acute hepatitis B was at a low level, the estimatedincidence rate declined from of 7.34/10 million in 2008 to 3.86/10 million in 2010. Conclusion The results showed that there was classified diagnostic error in NNDRS reporting hepatitis B cases and the reporting data of NNDRS did not reflect the real incidence level of hepatitis B. It was necessary to make a reporting standard of hepatitis B and carry out effective laboratory monitoring in order to improve the monitoring quality.

关 键 词：乙型病毒性肝炎 法定传染病报告系统 评价 

分 类 号：R512.62[医药卫生—内科学]