武威市某社区人群HBsAg携带者自发性再激活的流行病学特征  

Epidemiological characteristics of the spontaneous reactivation of HBV carriers in community population in Wuwei City

作　　者：孙国栋[1] 王安辉[1] 王宇飞[1] 蒲中枢[1] 付婷[1] 王洋[1] 闫永平[1] SUN Guo-dong WANG An-hui WANG Yu-fei PU Zhong-shu FU Ting Wang Yang YAN Yong-ping.(Department of Epidemiology, Factdty of Preventive Medicine, the Fourth Military Medical University, Xi＇an 710032, China)

机构地区：[1]第四军医大学军事预防医学院军队流行病学教研室,陕西西安710032

出　　处：《中华疾病控制杂志》2017年第4期332-335,共4页Chinese Journal of Disease Control & Prevention

基　　金：国家自然科学基金(81473026);国家传染病防治科技重大专项(2012ZX10004907)

摘　　要：目的分析社区人群乙型肝炎表面抗原(hepatitis B surface antigen,HBsAg)携带者发生自发性再激活的流行病学特征,为社区人群乙型肝炎的防控和管理提供科学依据。方法在2010年9月甘肃省武威市乙型肝炎血清流行病学调查建立的HBsAg携带者队列基础上,于2012年和2014年开展随访研究,分析自发性再激活的发生情况和流行病学特征。结果随访发现,852例HBsAg携带者中共有72例发生再激活,发病密度为2 746.8/10万人年。不同性别间再激活率差异存在统计学意义(x^2=3.901,P=0.048),男性累积再激活率为10.39%,高于女性累积再激活率(6.62%)。各年龄组间再激活率也存在统计学差异(x^2=6.524,P=0.038),其中46~59岁年龄组累积再激活率最高,为11.95%。HBsAg携带者基线乙型肝炎病毒(hepatitis B virus,HBV)DNA水平不同,再激活率也不同(x^2=10.404,P=0.006),当HBV DNA基线水平>1×10~5IU/ml时,累积再激活率可达14.36%。结论社区HBsAg携带者中存在一定比例的自发性再激活,其中男性、中年人群和基线HBV DNA水平较高者易发生再激活,应进一步加强HBV携带者的管控工作,对其定期进行随访监测,合理选择抗病毒治疗时机。Objective To analyze the epidemiological characteristics of the spontaneous reactivation of hepatitis B surface antigen（ HBsA g） carriers in the community,and to provide a scientific management for the chronic hepatitis B virus（ HBV） carriers. Methods A serum epidemiological cross-sectional study was conducted in September 2010,and the HBsA g carriers cohort was established. Then the cohort was followed in 2012 and 2014 to clarify the HBV reactivation rate and epidemiological characteristics. Results After the follow-up,there were 72 carriers developed to HBV reactivation of852 HBsA g carriers. The spontaneous reactivation incidence was 2 746. 8 per one hundred thousand person-years. Different reactivation rate were observed in different gender（ χ^2= 3. 901,P = 0. 048）. The male accumulated reactivation rate was10. 39%,which was higher than that of the female（ 6. 62%）. Meanwhile,significant differences were also found in different age groups（ χ^2= 6. 524,P = 0. 038）. The reactivation rate of 46-59 age group was 11. 95%. Besides,when the deoxyribonucleic acid of hepatitis B virus（ HBV DNA） level was high,the reactivation incidence was rising（ χ^2= 10. 404,P =0. 006）. Especially in the HBV DNA level 〉1 × 10^5IU/ml group,the reactivation rate could reach 14. 36%. Conclusions The HBsA g carriers may develop to HBV reactivation among community. Male,middle-age period and high baseline HBV DNA load are important risk factors for hepatitis B virus（ HBV） reactivation. Therefore,we should enhance the management of HBV carriers,conduct regular follow-up to monitor the condition change,and choose the reasonable time to initiate treatment.

关 键 词：医院 社区 肝炎表面抗原 乙型 流行病学研究 

分 类 号：R512.62[医药卫生—内科学] R181.2[医药卫生—临床医学]