广西乙型病毒性肝炎高流行区育龄妇女血清流行病学调查  

Seroepidemiology of hepatitis B virus infection among women of childbearing age in high endemic area of Guangxi

作　　者：黎沙 杜进发[1] 钟革[1] 杨仁聪[1] 邓秋云[1] 董爱虎[1] LI Sha;DU Jin-fa;ZHONG Ge;YANG Ren-chong;DENG Qiu-yun;DONG Ai-hu(Guangxi Zhuang Autonomous Region Center for Disease Prevention and Control, Nanning, Guangxi 530028, Chin)

机构地区：[1]广西壮族自治区疾病预防控制中心,广西南宁530028

出　　处：《应用预防医学》2018年第2期108-112,117,共6页Applied Preventive Medicine

基　　金：国家"十二五"科学技术艾滋病和病毒性肝炎等重大传染病防治重大专项乙型肝炎病毒免疫预防新策略的研究课题(2012ZX10002001-002-003);广西卫生厅自筹科研课题(Z2014161);广西卫生厅自筹科研课题(Z2016721)

摘　　要：目的了解广西乙型病毒性肝炎(以下简称乙肝)高流行区育龄妇女乙肝病毒感染现状。方法 2013年4月—9月选择广西区内乙肝高流行区中的北流市、桂平市、鹿寨县,采用分层随机抽样方法进行调查。每个县(市)随机抽取乡镇(镇、街道,下同),每个乡镇抽取1个村(居委会)作为调查点。根据文献资料估测15~19岁、20~29岁、30~39岁和40~49岁不同年龄段的调查样本量,从调查点全部育龄妇女中随机抽取各年龄段的相应样本。采用统一问卷调查人口学特征、肝炎患病史、乙肝病毒暴露史、乙肝疫苗免疫史等,问卷调查结束后采集各调查对象5 m L静脉血,用酶联免疫吸附试验(ELISA)检测乙肝血清学标志物。结果共调查育龄妇女1 722人,HBsAg、anti-HBs、HBeAg、anti-HBe、anti-HBc阳性率分别为9.00%、51.45%、3.02%、9.76%及26.07%。不同年龄组间HBsAg、HBeAg、anti-HBe、anti-HBc阳性率均存在明显统计学差异(P均<0.001),且HBsAg、HBeAg、anti-HBe阳性率以20~29岁年龄组为最高(分别为15.71%、6.73%、16.21%)。不同职业及不同文化程度育龄妇女HBsAg、anti-HBs、anti-HBe、anti-HBc阳性率均存在明显统计学差异(P均<0.001),职业以农民的HBsAg和HBeAg阳性率最高(分别为12.58%和3.47%);文化程度为初中的育龄妇女HBsAg、HBeAg、anti-HBe阳性率最高(分别为14.00%、4.00%、15.83%);生育过孩子的育龄妇女HBsAg、anti-HBe、anti-HBc阳性率明显高于未生育孩子的,差异均有统计学意义(P均<0.001);不同Hep B接种情况的育龄妇女HBsAg、anti-HBs、anti-HBe、anti-HBc阳性率均存在统计学差异(均P<0.05)。结论实施乙肝疫苗计划后广西乙肝防治取得一定成效,但高流行区育龄妇女的乙肝流行仍处于较高水平,应有针对性地对育龄妇女进行健康教育和筛查,以便采取有效的预防干预和治疗措施。Objective To understand the current situation of hepatitis B virus（HBV） infection in the women of childbearing age in high endemic rural areas of Guangxi. Methods A population-based study was carried out in 2013,which included women aged 15-49 years enrolled by a stratified random sampling from Beiliu City,Guiping City,and luzhai County of Guangxi. One township was randomly selected from each city/county and one village was selected at ramdom from each sampled township as the investigating site. The number of samples needed for 15-19, 20-29, 30-39 and 40-49 years age groups were estimated based on the prevalences of HBV in different age groups of wemon reported in one reference and the investigated targets were randomly chosed from the wemen of childbearing age in the 3 sites. A questionare survey was conducted to collect the data of demographic characteristics, the history of hepatitis, the history of hepatitis B virus exposure and the immunization history of hepatitis B vaccine; and 5 ml of blood was taken for detection of HBV serological markers by enzyme-linked immunosorbent assay（ELISA）. Results The study recruited 1722 women of childbearing age and the positive rates of HBsAg, anti-HBs, HBeAg, anti-Hbe and Anti-HBc were 9.00%,51.45%, 3.02%, 9.76% and 26.07%,respectively.There was significant difference between different age groups in the positive rates of HBsAg, HBeAg, anti-Hbe, anti-HBc（P0.001）; and the positive rates of HBsAg, HBeAg, anti-Hbe, in group of 20-29 years old were the highest with a rate of 15.71%, 6.73%, and 16.21%, respectively. The positive rates of HBsAg, anti-HBs, anti-Hbe and anti-HBc were different among different groups of occupation or education level（P0.001）, with the highest HBsAg and HBeAg positive rates in farmer group（12.58% and 3.47%） and the highest HBsAg, HBeAg, anti-Hbe positive rate in the group having junior middle school level of education（14.00%, 4.00%, 15.83%）. Multipara had higher positive rate of HBsAg or anti-Hbe than unipara（P0.001）. The r

关 键 词：育龄妇女 乙型病毒性肝炎 血清流行病学 

分 类 号：R512.62[医药卫生—内科学]