甘肃省武威市孕产妇HBsAg筛检和新生儿乙肝疫苗接种情况调查  

Investigation on HBsAg screening among pregnant women and first dose Hepatitis B vaccination of newborns in Wuwei City of Gansu Province

作　　者：王建勋[1,2] 张维璐[1] 王廷材 张磊[1] 王兴国[2] 吉兆华[1] 董冰[2] 闫永平[1] 

机构地区：[1]第四军医大学流行病教研室,陕西省西安市710032 [2]甘肃省武威市疾病预防控制中心

出　　处：《职业与健康》2014年第7期936-939,共4页Occupation and Health

基　　金：国家"十一五"重大传染病防治科技重大专项(项目编号:2012ZX10004907);国家自然科学基金青年项目(项目编号:81302474;项目编号:81102140)资助

摘　　要：目的摸清国家乙型病毒性肝炎(简称乙肝)防治示范区—甘肃省武威市孕产妇乙肝表面抗原(HBsAg)筛查情况及新生儿乙肝疫苗首针及时接种情况,为制定重点人群的乙肝防治策略、降低新生儿乙肝病毒感染率提供科学依据。方法以武威市一区三县129家市、县医院和乡镇卫生院为目标单位,采用分层整群随机抽样方法确定27家不同级别医院,调查对象为抽样医院内2009和2011年住院分娩的全体孕产妇。设计调查表,抽取调查对象的病历,采集相关信息数据,分析孕产妇HBsAg筛查率、阳性率及新生儿乙肝疫苗首针接种时间、及时接种率等指标。结果共调查武威市住院产妇病历15 015份,有HBsAg筛查记录者14 818份(98.69%),HBsAg阳性率为4.68%。汉族与藏族孕产妇HBsAg筛检率有显著性差异(χ2=30.98,P<0.01);县级以上医院HBsAg阳性率为5.66%,显著高于乡镇卫生院2.70%(χ2=63.81,P<0.01);剖腹产手术的孕产妇的HBsAg阳性率为7.41%,显著高于自然分娩孕产妇4.33%(χ2=31.88,P<0.01)。新生儿乙肝疫苗及时接种率为95.91%,未及时接种原因主要为早产、难产及低体重儿,分别为337例(2.25%),52例(0.35%),224例(1.49%);顺产分娩的新生儿乙肝疫苗及时接种率也较剖腹产高(χ2=9.98,P<0.01)。结论武威市孕产妇HBsAg筛查率较高,有利于及时发现HBsAg阳性的孕产妇,阻断母婴传播。绝大多数乡镇卫生院采用试纸条法检测HBsAg,今后还需进一步加强更加敏感的酶联免疫吸附试验(ELISA)等方法的技术培训。新生儿乙肝疫苗首针接种率较高,但是还应制定剖腹产、早产、难产及低体重新生儿的乙肝疫苗接种规范。[ Objective ] To understand the current status of the HBsAg screening among pregnant women and the first dose hepatitis B vaccination of their newborns in the National HBV prevention and control demonstration areas in Wuwei city, then provide scien- tific basis for formulating the strategy of HBV prevention and control and decreasing the infection rate of HBV in newborns. [ Methods] 27 hospitals of different levels were selected by stratified and cluster sampling method from 129 hospitals at city, county and township levels in Wuwei city. All the pregnant women and their newborns of these hospitals in 2009 and 2011 were respond- ents. Based on the medical records, the relevant information was extracted, the screening rate and positive rate of HBsAg of preg- nant women and the time and timely coverage rate of the first dose hepatitis B vaccination of their newborns were analyzed. [Results]Among 15 015 medical records of pregnant women, 14 818 had HBsAg screening record. The screening rate was 98.69%, and the HBsAg positive rate was 4.68%. The screening rate had a significant difference between the Han and Zang na- tionality （x2 = 30.98, P 〈0.01 }. The HBsAg positive rate in hospitals above the county level was significant higher than that in township hospitals （ 5.66% VS 2.70%, x2 = 63.81, P 〈 O. 01 ）. The HBsAg positive rate of the pregnant women with the caesare- an operation was significant higher than that with natural childbirth （ 7.41% VS 4.33%, x2 = 31.88, P 〈 0.01 }. The rate of the first dose hepatitis B vaccination in time is 95.91%. The timely coverage rate of hepatitis B vaccine in newborns was 95.91%, The main reasons of failed to timely vaccination were premature birth （2.25% }, dystocia （0.35% } and low birth weight （1.49% }. The timely coverage rate of hepatitis B vaccine in newborns of natural birth was also significant higher than that of caesarean opera- tion （x2 = 9.98 ,P 〈 0. O1 ）. [ Conclusion] There is a high HBsAg screening rate of pregnant women in Wuwei city, whi

关 键 词：孕产妇 HBSAG 感染率 乙肝疫苗接种 

分 类 号：R135[医药卫生—劳动卫生]