泰州市孕妇乙型肝炎病毒感染现状及乙型肝炎疫苗计划免疫管理对其的影响  

Status of hepatitis B virus infection among pregnant women in Taizhou City and the influence of hepatitis B vaccine immunization management on the status

作　　者：孙鸿展 杨莉莉[1] 肖丽[2] 何义林[3] 唐璟[1] 汤小霞[1] 王欣茹 咸建春[2] Sun Hongzhan;Yang Lili;Xiao Li;He Yilin;Tang Jing;Tang Xiaoxia;Wang Xinru;Xian Jianchun(Department of Obstetrics and Gynecology,Taizhou People′s Hospital,Taizhou City 225300,Jiangsu Province,China;Department of Liver Diseases,Taizhou People′s Hospital,Taizhou City 225300,Jiangsu Province,China;Department of Scientfic Research Quality Management,Taizhou Center for Disease Control and Prevention,Taizhou City 225300,Jiangsu Province,China)

机构地区：[1]泰州市人民医院妇产科,江苏省225300 [2]泰州市人民医院肝病科,江苏省225300 [3]泰州市疾病预防控制中心科研质管科,江苏省225300

出　　处：《中华传染病杂志》2020年第6期337-341,共5页Chinese Journal of Infectious Diseases

基　　金：泰州市科技支撑计划(社会发展)项目(TS201624);泰州市人民医院科研项目(ZL201626)。

摘　　要：目的分析近年来泰州市孕妇乙型肝炎病毒(hepatitis B virus,HBV)感染状况及乙型肝炎疫苗计划免疫管理对其的影响。方法以2014年至2017年在泰州市人民医院、泰州市第二人民医院、泰州市中医院、泰兴市人民医院住院的孕妇为研究对象,按其HBV血清学标志物检测结果分成无免疫者、免疫成功者、既往HBV感染者、HBV感染者和非典型表现者。以1992年为实施乙型肝炎疫苗计划免疫管理年,按孕妇分娩年度及实施疫苗接种前后分别分析其HBV感染状况。统计学方法采用χ^2检验和趋势性χ^2检验。结果最终被纳入的31449例孕妇中,无免疫者13203例(41.98%),免疫成功者10123例(32.19%),既往HBV感染者6409例(20.38%),HBV感染者1566例(4.98%),非典型表现者148例(0.47%)。1992年前和1992年后(含1992年)出生孕妇的HBV血清学标志物全阴率分别为42.07%(10794/25657)和41.59%(2409/5792),差异无统计学意义(χ^2=0.44,P=0.51)。1992年前出生孕妇的乙型肝炎表面抗体(hepatitis B surface antibody,抗-HBs)阳性率为28.95%(7428/25657),低于1992年后(含1992年)的46.53%(2695/5792),差异有统计学意义(χ^2=668.94,P<0.01),且呈逐年上升趋势(χ^2=602.11,P<0.01)。1992年后(含1992年)出生孕妇的乙型肝炎核心抗体(hepatitis B core antibody,抗-HBc)阳性率为8.81%(510/5792),低于1992年前出生孕妇的22.99%(5899/25657),差异有统计学意义(χ^2=589.10,P<0.01),且总体呈逐年下降趋势(χ^2=478.72,P<0.01)。1992年前出生孕妇的乙型肝炎表面抗原(hepatitis B surface antigen,HBsAg)阳性率为5.46%(1402/25657),高于1992年后(含1992年)出生孕妇的2.83%(164/5792),差异有统计学意义(χ^2=69.23,P<0.01),且总体呈下降趋势(χ^2=49.25,P<0.01)。HBV感染孕妇中,乙型肝炎e抗原(hepatitis B e antigen,HBeAg)阴性率为78.16%(1224/1566)。结论泰州市HBV感染孕妇以HBeAg阴性者为主;乙型肝炎疫苗计划免疫管理降低了孕妇的HBsAg和抗-HBc的阳性率,提高了抗-HObjective To analyze the status of hepatitis B virus(HBV)infection in pregnant women in Taizhou City in recent years and the effect of immunization management of hepatitis B vaccine project on the status.Methods The pregnant women hospitalized in Taizhou People′s Hospital,Taizhou Second People′s Hospital,Taizhou Traditional Chinese Medicine Hospital and Taixing People′s Hospital from 2014 to 2017 were enrolled.According to the HBV serological results,the pregnant women were divided into non-immune population,successful immunization population,previous HBV infection population,HBV infection population and atypical manifestation population.The year of immunization management for the implementation of the hepatitis B vaccine plan was 1992.The HBV infection status of the pregnant women was analyzed based on the year of delivery and vaccination status,respectively.Chi-square test and trend chi-square test were used for statistical analysis.Results A total of 31449 cases were included in this study,of which 13203(41.98%)were non-immunized,10123(32.19%)were successfully immunized,6409(20.38%)were previous HBV infected,1566(4.98%)were HBV infected,and 148(0.47%)cases were atypical manifestation.The negative rate of all HBV serological markers of pregnant women born before 1992 and after 1992(including 1992)were 42.07%(10794/25657)and 41.59%(2409/5792),respectively,with no statistically significant difference(χ^2=0.44,P=0.51).The hepatitis B surface antibody(anti-HBs)positive rate of pregnant women born before 1992 was 28.95%(7428/25657),which was lower than 46.53%(2695/5792)of pregnant women born after 1992(including 1992).The difference was statistically significant(χ^2=668.94,P<0.01),and showed an upward trend year by year(χ^2=602.11,P<0.01).The hepatitis B core antibody(anti-HBc)positive rate of pregnant women born after 1992(including 1992)was 8.81%(510/5792),which was lower than 22.99%(5899/25657)of pregnant women born before 1992,the difference was statistically significant(χ^2=589.10,P<0.01),and the over

关 键 词：肝炎病毒 乙型 乙型肝炎疫苗 孕妇 免疫策略 

分 类 号：R512.62[医药卫生—内科学]