中国2013-2020年乙型肝炎发病情况估算和病例特征分析  

Estimation of incidence of viral hepatitis B and analysis on case characteristics in China,2013-2020

作　　者：缪宁[1] 王富珍[1] 郑徽[1] 张国民[1] 尹遵栋[1] Miao Ning;Wang Fuzhen;Zheng Hui;Zhang Guomin;Yin Zundong(Department of National Immunization Program,Chinese Center for Disease Control and Prevention,Beijing 100050,China)

机构地区：[1]中国疾病预防控制中心免疫规划中心,北京100050

出　　处：《中华流行病学杂志》2021年第9期1527-1531,共5页Chinese Journal of Epidemiology

基　　金：中国成人高危人群和社区人群乙肝疫苗优化免疫策略研究(2018ZX10721202);中国慢性病毒性肝炎流行现状研究(2017ZX10105015);2021年公共卫生应急反应机制的运行-计划免疫项目(131031001000200001)。

摘　　要：目的为了解我国乙型肝炎(乙肝)病例的发病特征,为评估我国消除乙肝目标的实现情况,制定乙肝防控规划提供科学依据。方法对2013-2020年我国高、中、低流行区的全国法定传染病报告系统(NNDRS)中报告的乙肝病例进行调查,分析报告的病例的诊断信息,通过报告信息和诊断信息对2013-2020年的乙肝病例发病情况进行估算。分析急性乙肝和慢性乙肝的病例特征。结果NNDRS中共报告了27013例病例,其中急性乙肝病例4070例,慢性乙肝病例21971例,未分类乙肝病例972例。报告急性乙肝病例中,诊断为急性乙肝的占69.9%(2845/4070),报告慢性乙肝病例中,诊断为急性乙肝的占2.1%(452/21971),诊断为慢性乙肝的占89.0%(19548/21971)。通过对发病情况进行估算,2013-2020年全国估计急性乙肝发病率为4.6/10万,慢性乙肝发病率为54.5/10万。急性乙肝中以31~45岁组最多,占35.3%(1164/3297),≤15岁儿童仅占0.4%(13/3297)。慢性乙肝中以46~60岁组最多,占34.4%(7211/20932)。结论我国急性乙肝发病率逐年下降,慢性乙肝发病率有上升趋势,应进一步加强对慢性乙肝的规范化诊断和治疗,降低因慢性乙肝导致的疾病转归和死亡的发生。同时需要对NNDRS中报告的乙肝病例报告进行规范化的管理和报告,以提高乙肝病例分类报告的准确性。Objective To understand the epidemiological characteristics of hepatitis B in China,evaluate the performance of elimination hepatitis B in China and provide scientific evidence for the prevention and control of hepatitis B.Methods An analysis was conducted by using the data of hepatitis B cases reported to the National Notifiable Disease Reporting System(NNDRS)from the areas with low,moderate and high hepatitis B prevalence in China from 2013 to 2020,and the information about the diagnoses of the hepatitis B cases were collected,the incidence of hepatitis B was estimated according to the reporting and diagnosis information and the characteristics of acute and chronic hepatitis B were compared.Results A total of 27013 hepatitis B cases were reported to NNDRS,including 4070 acute cases,21971 chronic cases and 972 unclassified cases.Among the reported acute hepatitis B cases,69.9%(2845/4070)were confirmed.Among the reported chronic hepatitis B cases,89.0%(19548/21971)were confirmed,and 2.1%(452/21971)were confirmed as acute cases.It was estimated that the incidence of acute hepatitis B was 4.6/100000 and the incidence of chronic hepatitis B cases was 54.5/100000.The case number of acute hepatitis B in age group 31-45 years was highest,accounting for 35.3%(1164/3297).The case number of acute hepatitis B in children under 15 years old was lowest,accounting for 0.4%(13/3297).The case number of chronic hepatitis B in age group 46-60 years was highest,accounting for 34.4%(7211/20932).Conclusions The incidence of acute hepatitis B was in decrease and the incidence of chronic of hepatitis B was in increase in China year by year.It is important to strengthen the standardized diagnosis and treatment of chronic hepatitis B to decrease the morbidity and mortality of hepatitis B.At the same time,it is necessary to standardize the management and reporting of hepatitis B cases reported to NNDRS to improve the accuracy of the reporting of hepatitis B.

关 键 词：乙型肝炎 发病 估算 特征 

分 类 号：R512.62[医药卫生—内科学] R181.3[医药卫生—临床医学]