生存分析法在疫苗接种率评价中的应用研究  

Application of survival analysis on evaluation of vaccination coverage rate

作　　者：唐田[1,2] 张敬旭[1] 

机构地区：[1]北京大学公共卫生学院,北京100191 [2]北京市丰台区疾病预防控制中心,北京100071

出　　处：《职业与健康》2016年第9期1240-1244,共5页Occupation and Health

摘　　要：目的利用生存分析方法,评价乙型肝炎（乙肝）、卡介苗、麻疹、百白破、脊髓灰质炎（脊灰）5种疫苗基础免疫接种情况,为预防接种管理政策提供科学依据。方法采用分层随机整群抽样方法,将北京市丰台区按照地理位置分为西部、中部、东部3层,从每一层内随机抽取1个街乡,调取该街乡预防接种单位儿童预防接种信息管理系统内儿童个案进行数据分析。结果共收集0～5岁在册儿童个案16 495名。乙肝、麻疹、百白破、脊灰疫苗基础剂次全程推荐月龄时点累计接种率,本市儿童分别为68.7%、91.5%、77.6%、83.5%,外省市儿童分别为57.9%、81.6%、61.8%、67.4%;乙肝、麻疹、百白破、脊灰疫苗基础剂次全程12月龄时点累计接种率,丰台区儿童分别为99.4%、99.3%、99.4%、99.6%,外省市儿童分别为98.3%、98.7%、98.1%、98.7%;乙肝第1剂次、卡介苗出生后24 h时点累积接种率,丰台区儿童分别为93.2%、67.5%,外省市儿童分别为93.2%、65.9%。经对数秩检验（Log rank法）,除卡介苗以外,丰台区儿童与外省市儿童的其余疫苗剂次接种差异均有统计学意义（均P〈0.01）。结论生存分析法不仅可以有效评价儿童预防接种率,而且对于完善预防管理政策,可提供科学依据。[Objective]To evaluate the coverage rate of five vaccines（including hepatitis B,BCG,MV,DPT and PV） by survival analysis,and provide scientific evidence for vaccination management.[Methods] By the stratified randomized cluster sampling method,the Fengtai District of Beijing was divided into the western area,central area and eastern area,and one township/subdistrict was selected randomly from each area,and the data from Child Immunization Information Management System in the township/subdistrict were collected and analyzed.[Results]Totally 16 495 children aged 0-5 years old were enrolled. The ageappropriate cumulated vaccination coverage rate of hepatitis B,MV,DPT and PV among the local children was respectively68.7%,91.5%,77.6% and 83.5%,and that among floating children was respectively 57.9%,81.6%,61.8% and 67.4%. The 12 months cumulated vaccination coverage rate of hepatitis B,MV,DPT and PV among the local children was respectively 99.4%,99.3%,99.4% and 99.6%,and that among floating children was respectively 98.3%,98.7%,98.1% and 98.7%. The 24 hours cumulated vaccination coverage rate of the first dose of hepatitis B and BCG among the local children was respectively 93.2% and67.5%,and that among floating children was respectively 93.2% and 65.9%. Log rank analysis showed that there were statistically significant differences in vaccination coverage rate of the vaccines（except for BCG） between local children and nonlocal registered permanent children（P〈0.01）.[Conclusion]Survival analysis can provide not only effective assessment on vaccination coverage in children,but also scientific evidence for vaccination management.

关 键 词：儿童预防接种 接种率 接种延迟 生存分析法 

分 类 号：R186[医药卫生—流行病学]