深圳市宝安区HBsAg阳性产妇所生儿童免疫后血清学检测现状  

Current status of post-vaccination serological test after children born among HBsAg-positive mothers in Baoan District of Shenzhen City

作　　者：王维[1] 罗雅丽[1] 唐伟平 陈佳虹 王利玲 WANG Wei;LUO Ya-li;TANG Wei-ping;CHEN Jia-hong;WANG Li-ling(Shenzhen Baoan Women's and Children's Hospital,Shenzhen 518102,China)

机构地区：[1]深圳市宝安区妇幼保健院,广东深圳518102

出　　处：《中国健康教育》2021年第10期880-883,共4页Chinese Journal of Health Education

基　　金：深圳市宝安区科技计划项目(2020JD117);中国性病艾滋病防治协会·艾伯维妇幼关爱及预防母婴传播基金(2020PMTCT-S3)。

摘　　要：目的掌握深圳市宝安区HBsAg阳性产妇所生儿童免疫后血清学检测(Post-vaccination serological test,PVST)现状,分析影响PVST开展的因素。方法以2017年6月至2019年12月HBsAg阳性产妇所生活产儿为研究对象,各社康中心和助产医院于儿童7—15月龄时进行随访并填报随访登记卡。结果宝安区乙肝暴露儿童随访成功率为81.71%(9520/11651),完成乙肝疫苗全程接种后在15月龄内进行PVST 5132例,PVST比例为53.91%(5132/9520)。其中:免疫接种成功5042例(98.25%),免疫接种无应答72例(1.40%),免疫接种失败18例,乙肝母婴传播率为0.35%。Logistic回归分析显示,母亲为深圳户籍(OR=1.142,P=0.018)、文化程度为大专及以上(OR=1.362,P<0.001)、初检孕周<13周(OR=1.441,P<0.001)和分娩医院为公立医院(OR=1.308,P<0.001)的乙肝暴露儿童PVST比例更高。未进行PVST的前3位原因分别是:家长不知道应该为孩子检测(2061例,65.18%),孩子已回老家无法安排检测(323例,10.22%)和家长忘记带孩子去检测(270例,8.54%)。结论在"社康-医院一体化"服务模式下,宝安区乙肝暴露儿童的随访和监测工作取得了一定进展,但仍须创新宣教策略,提高基层服务供给能力,进一步提升乙肝暴露儿童PVST比例。Objective To investigate the status of post-vaccination serological test(PVST)after children born among HBsAg-positive mothers in Baoan District of Shenzhen,and to analyze the influencing factors of PVST.Methods The live births of HBsAg-positive mothers born from June 2017 to December 2019 were enrolled as study objects.When the children were 7-15 months old,follow-up survey was conducted in community health service centers and midwifery hospitals and the follow-up registration card were filled out.Results The follow-up success rate of children exposed to HBV in Baoan District was 81.71%(9520/11651).A number of 5132 children underwent PVST within 15 months of age,and the proportion of PVST was 53.91%(5132/9520).Among them,5042 cases(98.25%)were successful in immunization,72 cases(1.40%)were unresponsive to immunization,18 cases were failed in immunization,and the mother-to-child transmission rate of hepatitis B was 0.35%.Logistic regression analysis showed that PVST was associated with mother′local household registration(OR=1.142,P=0.018),higher education level(OR=1.362,P<0.001),took the first prenatal examination before 13 weeks of gestation(OR=1.441,P<0.001)and delivered in public hospital(OR=1.308,P<0.001).The top 3 reasons for not undergoing PVST were:parents did not know that their baby should be tested(2061 cases,65.18%),the baby had returned to hometown(323 cases,10.22%)and the parents forgot to take their baby for testing(270 cases,8.54%).Conclusion Under the"community-hospital integration"service model in Baoan District,certain progress has been made in the follow-up and monitoring of children exposed to HBV,but it is still necessary to innovatethe publicity and education strategies and improve the ability of grassroots services to further increase PVST of children exposed to HBV.

关 键 词：HBSAG阳性 乙肝暴露儿童 免疫后血清学检测 随访 

分 类 号：R193[医药卫生—卫生事业管理]