江苏省丹阳市乙型肝炎表面抗原阳性人群就诊行为及其影响因素  

Health care use of hepatitis B surface antigen positive individuals in Danyang city of Jiangsu province

作　　者：管芳[1] 周羚[1] 朱立国[1] 姜洁[1] 徐建芳[2] 翟祥军[1] Guan Fang;Zhou Ling;Zhu Liguo;Jiang Jie;Xu Jianfang;Zhai Xiangjun(Jiangsu Provincial Center for Disease Control and Prevention,Nanfing 210009,Jiangsu,China;Danyang Municipal Center for Disease Control and Prevention,Zhenjiang 212300,Jiangsu,China)

机构地区：[1]江苏省疾病预防控制中心,江苏南京210009 [2]丹阳市疾病预防控制中心,江苏镇江212300

出　　处：《中国疫苗和免疫》2018年第5期544-548,共5页Chinese Journal of Vaccines and Immunization

基　　金：国家科技重大专项(2013ZX10004905);国家自然科学基金(81673244)

摘　　要：目的了解江苏省丹阳市乙型肝炎（乙肝）表面抗原（HBsAg）阳性人群的就诊行为及其影响因素。方法选择丹阳市2009年调查发现并参加随访的HBsAg阳性人群开展问卷调查、临床检查和实验室检测,对数据进行描述性分析,采用Logistic回归分析就诊行为的影响因素。结果在1 677例HBsAg阳性随访人群中,曾去医院进行疾病诊断和治疗256例（15.27%）;每年至少参加1次体检215例（87.04%）;采取治疗措施173例（67.58%）,其中慢性乙肝、肝硬化/疑似肝癌采取抗病毒治疗分别占77.08%（111/144）、62.50%（5/8）;在未就诊的1 421例HBsAg阳性人群中,78.82%认为不必去医院,24.00%因为医生未建议,5.98%因为经济负担重,0.28%担心无治疗效果。Logistic回归分析显示,家庭年收入、临床分型是影响HBsAg阳性人群就诊行为的因素。结论丹阳市HBsAg阳性人群就诊率偏低,应加强健康教育以提高其乙肝防治意识和就诊积极性。Objective To analyze heath care seeking behavior and its influencing factors among hepatitis B surface antigen（HBsAg） positive individuals in Danyang city. Methods We recruited HBsAg-positive subjects who had been identified in a 2009 baseline survey in Danyang and who had attended follow-up visits to participate in a questionnaire-based investigation with physical examinations and laboratory testing. Data were analyzed descriptively. Factors influencing the behavior of medical visits were identified with logistic regression. Results Among 1 677 HBsAg-positive subjects, 256（15.27%） had been to a hospital for diagnosis and treatment; 215（87.04%） had had physical examinations at least once a year; 173（67.58%） had received treatments, in which 77.08%（111/144） of chronic hepatitis B cases, and 62.50%（5/8） of cirrhosis or suspected hepatocellular carcinoma cases had received antiviral therapy. Among 1 421 HBsAg-positive subjects who did not have medical visits, 78.82% thought that medical visits were unnecessary, 24.00% had not received advice from a doctor to have a medical visit, 5.98% did not have a medical visit due to high cost, and 0.28% were concerned that treatment is not effective. Logistic regression showed that annual family income and clinical situation could influence medical visit seeking behavior among HBsAg-positive individuals. Conclusions The rate of medical visits was low among HBsAg-positive individuals in Danyang. Health education should be strengthened to improve awareness of hepatitis B prevention and appropriate health care use.

关 键 词：乙型肝炎 乙型肝炎表面抗原 就诊 影响因素 

分 类 号：R512.6[医药卫生—内科学]