联合免疫阻断乙肝病毒母婴传播后儿童HBV感染的危险因素及预测模型构建  

Risk factors for HBV infection in children after combined immunosuppression of mother-to-child transmission of hepatitis B virus and establishment of prediction model

作　　者：薛莉莉[1] 陈丽平[1] 蒋玲玲[1] 汤卫春[1] 马红燕 XUE Li-li;CHEN Li-ping;JIANG Ling-ling;TANG Wei-chun;MA Hong-yan(Nantong First People's Hospital(The Second Affiliated Hospital of Nantong University),Nantong,Jiangsu 22600l,China)

机构地区：[1]南通市第一人民医院(南通大学第二附属医院)妇产科,江苏南通226001

出　　处：《中华医院感染学杂志》2024年第1期108-111,共4页Chinese Journal of Nosocomiology

基　　金：江苏省卫生健康委科研项目(M2020037);南通市卫生健康委科研项目(MSZ2022016)。

摘　　要：目的探讨联合免疫阻断乙肝病毒母婴传播儿童乙肝病毒(HBV)感染的危险因素,并构建预测模型。方法选取629例2018年4月-2022年12月南通市第一人民医院收治的乙肝表面抗原(HBsAg)阳性母亲及其所生儿童为研究对象,其中联合免疫阻断乙肝病毒母婴传播后HBV感染25例为研究组,未发生HBV感染604例为对照组,多因素Logistic回归分析儿童HBV感染的危险因素,受试者工作特征(ROC)曲线分析儿童HBV感染预测模型的临床价值。结果母亲分娩年龄≤28岁、母亲HBeAg阳性是联合免疫阻断乙肝病毒母婴传播后儿童HBV感染的独立危险因素(P<0.05);据此构建的回归模型为Logit(P)=-10.986+母亲分娩年龄≤28岁×0.859+母亲HBeAg阳性×0.794,当Logit(P)>11时,预测儿童HBV感染的曲线下面积(AUC)为0.854,敏感度为88.00%,特异度为69.54%。结论母亲分娩年龄≤28岁、母亲HBeAg阳性是联合免疫阻断乙肝病毒母婴传播后儿童HBV感染的危险因素,据此构建的模型预测价值较高,临床可进行针对性防治以降低联合免疫阻断乙肝病毒母婴传播后儿童HBV感染的风险。OBJECTIVE To explore the risk factors for hepatitis B virus(HBV)infection in the children after com-bined immunosuppression of mother-to-child transmission of HBV and establish the prediction model.METHODS A total of 629 mothers with positive hepatitis B surface antigen(HBsAg)and their children who were treated in the Nantong First People's Hospital from Apr 2018 to Dec 2022 were recruited as the research subjects.25 chil-dren who had HBV infection after combined immunosuppression of mother-to-child transmission of HBV were as-signed as the study group,and 604 children who did not have HBV infection were set as the control group.Multi-variate logistic regression analysis was performed for the risk factors for the HBV infection in the children.The clinical value of the prediction model for HBV infection was analyzed by means of receiver operating characteristic(ROC)curves.RESULTS The age of mother at delivery no more than 28 years old and positive HBeAg of mother were independent risk factors for the HBV infection in the children after combined immunosuppression of mother-to-child transmission of HBV(P<0.05).The regression model that was established based on the independent risk factors was as follows:Logit(P)=-10.986+age of mother at delivery no more than 28 years of age X0.859+positive HBeAg of motherX0.794,when Logit(P)was greater than 11,the area under curve(AUC)was 0.854 in prediction of the HBV infection in the children,with the sensitivity 88.00%,the specificity 69.54%.CONCLUSION The age of mother at de-livery no more than 28 years old and positive HBeAg of mother are the risk factors for the HBV infection in the children after combined immunosuppression of mother-to-child transmission of HBV.The model has high predictive value.It is necessary for the hospital to take targeted prevention measures so as to reduce the risk of HBV infection after combined immunosuppression of mother-to-child transmission of HBV.

关 键 词：乙肝病毒 母婴传播 乙肝表面抗原阳性 感染 危险因素 预测模型 

分 类 号：R183[医药卫生—流行病学]