医疗大数据分析有助于监测低年龄组乙肝表面抗原阳性率及评估免疫效果  

The real-word big data can be used to evaluate the HBsAg positive rate and immunity effects in children

作　　者：单姗[1] 李敏 田永谦 孔媛媛 尤红[1] 贾继东 SHAN Shan;LI Min;TIAN Yong-qian;KONG Yuan-yuan;YOU Hong;JIA Ji-dong(Liver Research Center,Beijing Friendship Hospital,Capital Medical University,National Clinical Research Center for Digestive Diseases,Beijing 100050,China;Shanghai Suvalue Health Scientific Ltd.,Shanghai 200032,China)

机构地区：[1]首都医科大学附属北京友谊医院肝病中心,100050 [2]国家消化系统疾病临床医学研究中心,100050 [3]上海溯直健康科技有限公司

出　　处：《肝脏》2020年第5期472-475,479,共5页Chinese Hepatology

摘　　要：目的 通过分析临床医疗大数据了解真实世界HBV感染情况和乙型肝炎(乙肝)疫苗免疫策略效果。方法筛选Suvalue数据库中自2006年1月至2017年7月有年龄、性别、HBsAg、抗-HBs、HBeAg和抗-HBc检查结果的数据(包括63家3级及2级医院)。分析总体、不同年龄段及不同性别人群HBsAg、抗-HBs、HBeAg和抗-HBc阳性率随时间变化趋势。并将HBsAg结果与2006年、2014年全国人群乙肝血清流行病学调查结果相比较。结果 共2 311 221人纳入研究,其中男性919 908人,女性1 391 313人。所研究人群的HBsAg、HBeAg及抗-HBc阳性率总体呈逐年下降趋势,分别由2006年的17.4%、7.1%、32.9%降至2017年的5.9%、2.3%、24.2%;而抗-HBs呈逐年上升趋势,由2006年的47.6%增加至2017年的56.4%。有意义的是,2006年及2014年1~4岁和5~14岁的HBsAg阳性率(分别为1.4%、9.1%和0.4%、0.9%)与同时期全国人群乙肝血清流行病学调查结果(0.96%、10.6%和0.3%、0.9%)相近(P<0.05)。结论 临床医疗大数据分析有助于了解真实世界小年龄组(<15岁)HBV感染状况,从而间接反映国家乙肝疫苗免疫规划的效果。Objective To better understand HBV infection status and the immunity effects of hepatitis B in the National Immunization Program in real-world clinical practice.Methods Data were retrieved from the SuValue database(including 63 tertiary and secondary hospitals across China)from January 2006 to July 2017.The positive rates of surface antigen(HBsAg),hepatitis B surface antibody(anti-HBs),and hepatitis B core anti-body(anti-HBc)were analyzed and compared with the results of the national seroepidemiological survey of hepatitis B in 2006 and 2014.Results A total of 2311221 participants were included in this study,including 919908 men and 1391313 women.From 2006 to 2007,the overall positive rates of HBsAg,HBeAg and anti-HBc declined from 17.4%,7.1%,32.9%to 5.9%,2.3%,24.2%,whereas the positive rate of anti-HBs increased from 47.6%to 56.4%.Interestingly,the HBsAg positive rate in the groups of 1-4 years and 5-14 years in 2006(1.4%and 9.1%)and 2014(0.4%and 0.9%)were close to that in the national seroepidemiological survey of hepatitis B conducted in 2006(0.96%and 10.6%)and 2014(0.3%and 0.9%,P<0.05).Conclusion The big data from real-world clinical practice can be used to monitor the HBsAg positive rate and evaluate the immunity effect of hepatitis B vaccine in the National Immunization Program those younger than 15 years old.

关 键 词：HBV 医疗大数据 真实世界 

分 类 号：R512.62[医药卫生—内科学] R446.6[医药卫生—临床医学]