浙江省乙型病毒性肝炎监测报告质量分析  

An analysis on the hepatitis B report data from a pilot surveillance in Zhejiang Province

作　　者：周洋[1] 何寒青[1] 邓璇[1] 严睿[1] 唐学雯[1] 谢淑云[1] 姚军[1] 符剑[1] 

机构地区：[1]浙江省疾病预防控制中心,浙江杭州310051

出　　处：《预防医学》2017年第9期865-868,873,共5页CHINA PREVENTIVE MEDICINE JOURNAL

基　　金：国家自然科学基金(31500751);浙江省医药卫生科技计划项目一般项目(2016KYA063)

摘　　要：目的分析浙江省2013—2015年乙型病毒性肝炎(乙肝)监测报告质量,为提高乙肝监测质量提供依据。方法从中国法定传染病报告系统导出2013—2015年桐乡、吴兴、南浔、柯桥、定海和普陀6个乙肝监测点报告的乙肝病例数量、分类和附卡信息等资料,根据附卡信息进行病例分类,评估乙肝报告分类的准确性。结果2013—2015年6个监测点共报告乙肝病例3 214例,重复病例32例,重复报告率为1.00%。实际报告乙肝病例3182例,准确分类2 717例,分类准确率为85.39%,并呈逐年上升趋势(P<0.05)。其中根据附卡信息的乙肝病毒表面抗原(HBs Ag)阳性时间准确分类的病例占80.86%;根据丙氨酸氨基转移酶(ALT)结果准确分类的病例占97.29%;根据乙肝病毒核心抗体(抗-HBc)Ig M结果准确分类的急性乙肝病例占急性乙肝病例报告总数的90.43%;根据肝穿刺结果准确分类的病例占0.19%;根据恢复期血清HBs Ag、乙肝病毒表面抗体(抗-HBs)结果准确分类的病例占5.13%。慢性、无法判断病例误报为急性乙肝病例占0.69%;急性、无法判断、乙肝携带者误报为慢性乙肝病例占13.92%;未分类5例,占0.16%。结论浙江省乙肝监测报告准确性已有所提高,但仍存在重复报告、急慢性病例混报、乙肝携带者误报为慢性乙肝等情况,填写附卡信息有利于乙肝病例准确分类。Objective To evaluate the quality of the hepatitis B report data on a pilot surveillance in Zhejiang Province from 2013 to 2015.Methods Hepatitis B report data of 6 pilots in Zhejiang Province from 2013 to 2015 were extracted from national notifiable infectious disease reporting system,including reported cases of hepatitis B,classification of hepatitis B cases and supplementary card information etc.To evaluate the accuracy of hepatitis B classification,information of supplementary cards was used to make classification diagnose for hepatitis B.Results A total of 3 214 hepatitis B cases were reported in 6 pilot surveillance counties in Zhejiang Province between 2013 and 2015.Excluded 32 duplicated cases within the year and between years,3 182 hepatitis B cases were actually reported,hepatitis B cases repeated reporting rate was 1%.A total of 2 717 hepatitis B cases were correctly classified,and the accuracy rate of classification was85.39%,showing an increasing trend（P0.05）.The proportion of accurate classification of reported hepatitis B by referring to the results of positive time of HBs Ag and ALT from the supplementary card were 80.86% and 97.29%respectively.Among those reported acute hepatitis B cases,90.43% of them filled with anti-HBc Ig M positive in supplementary card.The proportion of accurate classification of reported hepatitis B by referring to the information for liver puncture and the HBs Ag and anti-HBs transform during the recovery period in supplementary cards were 0.19% and5.13% respectively.Among those reported acute hepatitis B cases,0.69% of them were chronic or undetermined.Among those reported chronic hepatitis B cases,13.92% of them were acute,undetermined or HPV carrier.Five out of 3182 cases were unclassified,accounting for 0.16%.Conclusion The quality of classification diagnosis for hepatitis B should be improved in Zhejiang Province.Filling in the supplementary card is very beneficial for the classification of hepatitis B.

关 键 词：乙型病毒性肝炎 监测 诊断 

分 类 号：R512.62[医药卫生—内科学]