2018-2022年天津市急性乙型病毒性肝炎流行特征及病毒基因型分析  

Epidemic characteristics and viral genotypes of acute viral hepatitis B in Tianjin in 2018-2022

作　　者：张国平 王永馨 何海艳[1] 刘勇[1] 吴伟慎[1] ZHANG Guoping;WANG Yongxin;HE Haiyan;LIU Yong;WU Weishen(Tianjin Centers for Disease Control and Prevention,Tianjin 300011,China)

机构地区：[1]天津市疾病预防控制中心,天津300011

出　　处：《公共卫生与预防医学》2025年第2期17-21,共5页Journal of Public Health and Preventive Medicine

基　　金：中国肝炎防治基金会(YGFK20210058);天津市医学重点学科(专科)建设项目(TJYXZDXK-50A);国家疾控局公共卫生人才培养支持项目。

摘　　要：目的了解近年来天津市急性乙型病毒性肝炎(乙肝)的流行特点和基因型分布,寻找基因型与流行特征的关联。方法收集天津市2018-2022年国家传染病监测系统报告的现住址为天津的急性乙肝病例信息,通过医院系统查阅检验记录和电话调查随访病例转归,使用荧光PCR方法检测乙肝病毒(HBV)基因型。结果2018-2022年天津市报告现住址为本地的急性乙肝患者387例,年均报告发病率0.52/10万,总体呈下降趋势(χ^(2)=28.553,P<0.001);男女报告发病率之比1.68,年龄分布主要集中在30~65岁年龄段,其中35~39岁年龄组报告发病率最高(1.22/10万);72.87%的病例确诊6个月后随访HBsAg转阴;干部职员的转阴比例(92.16%)明显高于未转阴的比例(0%),转阴组ALT中位数(1508.00 U/L)明显高于未转阴组(976.00U/L);315份基因分型成功的病例中,81.27%为C基因型,14.92%为B基因型47例;B基因型急性乙肝患者的ALT中位数(1585.00 U/L)明显高于C基因型(988.00U/L)。结论天津市急性乙肝报告发病率较低,且呈下降趋势,青壮年男性好发,基因型以C基因型为主,B基因型的HBV对急性乙肝患者的肝脏损害更严重。Objective To understand the epidemic characteristics and genotype distribution of acute hepatitis B in Tianjin,and to find out the relationship between genotype and epidemic characteristics.Methods The information of acute hepatitis B cases with a local address in Tianjin was collected through the National Infectious Disease Surveillance System in Tianjin from 2018 to 2022.The patient outcomes were followed up through hospital system records and telephone survey,and hepatitis B virus(HBV)genotypes were detected by fluorescent PCR.Results From 2018 to 2022,there were 387 cases of acute hepatitis B with local address reported in Tianjin,with an average annual reported incidence rate of 0.52/100000,showing a downward trend in general(χ^(2)=28.553,P<0.001).The reported male to female incidence ratio was 1.68.The age distribution was mainly concentrated in the 30-65 age group,with the highest incidence rate(1.22/100000)reported in the 35-39 age group.72.87%of cases showed negative HBsAg after 6 months of follow-up following diagnosis.The proportion of cadres and staff who turned negative(92.16%)was significantly higher than that of those who did not turn negative(0%).The median ALT(1508.00 U/L)in the turning negative group was significantly higher than that in the non-turning negative group(976.00 U/L).Among 315 cases with successful genotyping,genotype C accounted for 81.27%,and genotype B accounted for 14.92%,with 47 cases.The median ALT of genotype B patients with acute hepatitis B(1585.00 U/L)was significantly higher than that of genotype C patients(988.00 U/L).Conclusion The reported incidence rate of acute hepatitis B in Tianjin is relatively low,and shows a downward trend.Young and middle-aged men are prone to infect HBV.Genotype C is the main genotype,and genotype B HBV causes more serious liver damage in patients with acute hepatitis B.

关 键 词：乙肝 急性 流行特征 基因型 

分 类 号：R181[医药卫生—流行病学]