湖南省1～59岁人群乙型肝炎病毒表面抗原和抗乙型肝炎病毒表面抗原抗体流行率调查  

Prevalence of Hepatitis B Virus Surface Antigen(HBsAg) and Antibody to HBsAg among 1-59 Year Olds,Hunan Province

作　　者：夏伟[1] 戴德芳[1] 宋立新[1] 颜洁[1] 孙倩莱[1] 肖洁华[1] 张帆[1] 高立冬[1] 李俊华[1] 李放军[1] 

机构地区：[1]湖南省疾病预防控制中心,长沙410005

出　　处：《中国疫苗和免疫》2015年第4期373-377,427,共6页Chinese Journal of Vaccines and Immunization

基　　金：湖南省2011年重大公共卫生专项(编号:2100409302)

摘　　要：目的为了解湖南省1-59岁人群乙型肝炎（乙肝）病毒表面抗原（Hepatitis B Virus Surface Antigen,HBs Ag）和抗乙肝病毒表面抗原抗体（Antibody to HBs Ag,Anti-HBs）流行率,掌握乙肝流行现况,评价乙肝疫苗（Hepatitis B Vaccine,Hep B）纳入儿童免疫规划后的效果,制定今后乙肝预防控制（防控）计划提供参考。方法采用分层三阶段整群随机抽样方法,第一阶段抽取县（市、区）,第二阶段抽取村（居委会）,第三阶段抽取调查对象个体。根据公式n=400×Q/P进行样本量估算,P（1-59岁人群HBs Ag流行率）按4%计算,本次调查需总样本量为9600。使用统计分析系统（Statistical Analysis System,SAS）9.4编程软件对本次的HBs Ag、Anti-HBs流行率调查资料进行统计分析。统计分析方法采用复杂调查设计为基础的估计方法进行参数估计,用调查设计权重进行总体率的加权估计,采用泰勒级数线性法估计率的方差。结果湖南省1-59岁人群HBs Ag、Anti-HBs流行率分别为7.23%、52.02%。城市人群HBs Ag、Anti-HBs流行率分别为6.09%、50.98%;农村人群HBs Ag、Anti-HBs流行率分别为8.33%、53.04%。男性HBs Ag、Anti-HBs流行率分别为8.18%、51.37%;女性HBs Ag、Anti-HBs流行率分别为6.27%、52.68%。1-4岁、5-14岁、15-59岁HBs Ag流行率分别为0.82%、1.71%、8.68%,Anti-HBs流行率分别为54.77%、55.25%、51.25%。结论湖南省Hep B纳入儿童免疫规划效果显著,1-4岁儿童HBs Ag流行率已降至〈1%。但乙肝防控形势仍然严峻,1-59岁人群HBs Ag流行率〉7%,仍属乙肝中度流行地区。Objective To determine the prevalence of hepatitis B virus surface antigen（ HBs Ag） and antibody to HBs Ag（ Anti-HBs）,describe the epidemiology of hepatitis B,evaluate the impact of hepatitis B vaccine（ Hep B） in the childhood immunization program,and provide evidence for developing further disease control and prevention strategies in Hunan province. Methods A stratified random cluster sampling was conducted using three levels： counties（ city or district） were selected at the first level stage,villages（ or residential communities） at the second level,and individuals at thethird level. Sample size was determined usingthe formula n = 400 × Q / P,in which P（ the prevalence rate of HBs Ag in population of aged1-59 year old） was set as 4%,yielding a desired sample size of 9600. Statistical Analysis System institute software 9. 4 was used to analyze HBs Ag and Anti-HBs prevalence rates. Analyses were conductedusing weightings to account for the complex survey design; Taylor series was used to determine point estimates and their variances. Results The prevalence rates of HBs Ag and Anti-HBs among 1-59 year olds were 7. 23% and 52. 02% respectively,and were 6. 09% and 50. 98% in urban settings,and 8. 33% and 53. 04% in rural settings. The prevalence rates of HBs Ag and Anti-HBs was8. 18% and 51. 37% among males,and 6. 27% and 52. 68% among females. The prevalence rate of HBs Ag amongchildren aged 1-4 and 5-14,and adults 15-59 years old were 0. 82%,1. 71%,and 8. 68%,respectively,while the Anti-HBs rates were 54. 77%,55. 25%,and 51. 25%. Conclusions Hep B vaccine had a clearly positive impact in the childhood immunization program. The prevalence of HBs Ag among children aged 1-4 was less than 1%. However,the current situation for control and prevention of Hep B is still a challenge. The overall prevalence rate of HBs Ag was above 7%,and Hunan province,therefore,is still classified as medium epidemic level.

关 键 词：1-59岁人群 乙型肝炎病毒表面抗原 抗乙型肝炎病毒表面抗原抗体 乙型肝炎疫苗 预防接种 

分 类 号：R512.62[医药卫生—内科学] R186[医药卫生—临床医学]