青岛市某医院2016-2020年孕产妇乙型肝炎病毒标志物血清流行率  

Sero-prevalence of hepatitis B virus markers among pregnant women in a hospital of Qingdao,2016-2020

作　　者：袁文清[1] 潘旻升 吕维红[1] 谭善娟[1] 张磊[1] 陈峰[1] Yuan Wenqing;Pan Minsheng;Lv Weihong;Tan Shanjuan;Zhang Lei;Chen Feng(Qingdao Municipal Hospital,Qingdao 266071,Shandong,China)

机构地区：[1]青岛市市立医院,山东青岛266071

出　　处：《中国疫苗和免疫》2021年第5期509-513,527,共6页Chinese Journal of Vaccines and Immunization

基　　金：国家自然科学基金青年基金项目(81502900)。

摘　　要：目的评价青岛市孕产妇乙型肝炎(乙肝)病毒(HBV)血清流行率。方法通过医院电子病历系统获得2016-2020年青岛市某医院就诊的所有孕产妇,采用化学发光微粒子免疫法检测血清乙肝表面抗原(HBsAg),对HBsAg阴性者检测乙肝表面抗体(HBsAb)和乙肝核心抗体(HBcAb),对HBsAg阳性者检测乙肝e抗原(HBeAg)和乙肝e抗体(HBeAb),分析血清HBV标志物流行率。结果在46682名孕产妇中,HBsAg总阳性率为3.36%(1567名),其中≤25岁、26-30岁、31-35岁、36-40岁、>40岁分别为2.02%、2.99%、3.58%、4.37%、4.15%。在36809名HBsAg阴性者中,HBsAb阳性率为62.47%(22994名),各年龄组分别为56.30%、63.08%、64.83%、60.21%、50.98%;HBcAb阳性率为4.02%(1480名),各年龄组分别为1.72%、3.45%、4.31%、5.98%、4.76%。在1274名HBsAg阳性者中,HBeAg阳性率为32.81%(418名),各年龄组分别为49.06%、37.95%、31.61%、25.00%、12.82%;HBeAb阳性率为65.54%(835名),各年龄组分别为49.06%、60.34%、67.10%、73.39%、82.05%。在乙肝疫苗(HepB)纳入免疫规划管理前和后出生的40977名和5705孕产妇中,HBsAg阳性率分别为3.55%(1456名)、1.95%(111名)(χ^(2)=39.89,P<0.001)。结论研究地区孕产妇HBV感染处于中低流行水平,新生儿HepB接种纳入免疫规划后显著减少了孕产期HBV感染;应推进成人HepB补种策略。Objective To evaluate sero-prevalence of hepatitis B virus(HBV)markers among pregnant women in Qingdao city.Methods We obtained clinical data on all pregnant women seen in a hospital of Qingdao during 2016-2020 from the hospital’s information system.We used a chemiluminescence microparticle immunoassay to test sera for hepatitis B surface antigen(HBsAg)of all pregnant women,hepatitis B surface antibody(HBsAb)and hepatitis B core antibody(HBcAb)among HBsAg negative pregnant women,and hepatitis B e antigen(HBeAg)and hepatitis B e antibody(HBeAb)among HBsAg positive pregnant women.We analyzed prevalence of serum HBV markers.Results Among 46682 pregnant women,3.36%(1567 subjects)were HBsAg positive;among these 46682 pregnant women who were≤25-,26-30-,31-35-,36-40-,and>40-years of age,2.02%,2.99%,3.58%,4.37%,and 4.15%were HBsAg positive.Among 36809 HBsAg negative subjects,62.47%(22994 subjects)were positive for HBsAb,and by respective age group,HBsAb positivity rates were 56.30%,63.08%,64.83%,60.21%,and 50.98%;4.02%(1480 subjects)were positive for HBcAb,with 1.72%,3.45%,4.31%,5.98%,and 4.76%positive by age group.Among 1274 HBsAg positive pregnant women,32.81%(418 subjects)were positive for HBeAg,with 49.06%,37.95%,31.61%,25.00%,and 12.82%positive by age group;65.54%(835 subjects)were positive for HBeAb,with 49.06%,60.34%,67.10%,73.39%,and 82.05%positive by age group.Among 40977 pregnant women born before hepatitis B vaccine(HepB)was introduced into the Expanded Program on Immunization(EPI),3.55%(1456 subjects)were HBsAg positive;among 5705 pregnant women born after HepB was introduced to EPI,1.95%(111 subjects)were HBsAg positive(χ^(2)=39.89,P<0.001).Conclusions The HBV infection rate remained at low to medium levels among pregnant women in the study area.Introduction of neonatal HepB vaccination into EPI was associated with significantly lower HBV prevalence in pregnant women when compared with HBV prevalence in pregnant women born before EPI introduction.We should promote HepB vaccination of adults.

关 键 词：乙型肝炎 乙型肝炎病毒 乙型肝炎疫苗 乙型肝炎病毒标志物 血清流行率 孕产妇 

分 类 号：R186[医药卫生—流行病学] R512.6[医药卫生—公共卫生与预防医学]