摘要
目的了解社区乙型肝炎表面抗原(HBs Ag)阳性人群血清流行病学特征,为乙型肝炎防治示范区现场研究提供基础数据。方法选取武威市2010—2014年乙型肝炎防治示范区经社区健康体检筛选及各社区卫生服务中心报告的HBs Ag阳性者为研究对象。采用自制的调查问卷收集研究对象人口学特征以及治疗情况。采集研究对象静脉血,检测HBs Ag、乙型肝炎表面抗体(HBs Ab)、乙型肝炎e抗原(HBe Ag)、乙型肝炎e抗体(HBe Ab)、乙型肝炎核心抗体(HBc Ab)等血清学指标,以及丙氨酸氨基转移酶(ALT)、天冬氨酸氨基转移酶(AST)、总胆红素(TBIL)、直接胆红素(DBIL)、谷氨酸转肽酶(GGT)、清蛋白(ALB)及甲胎蛋白(AFP)水平等生化指标。结果本研究获得由社区健康体检筛选或社区卫生服务中心报告的HBs Ag阳性者3 678例。HBs Ag阳性者血清学共有14种组合模式,HBs Ag、HBe Ab、HBc Ab阳性模式(模式1)占69.06%(2 540/3 678),HBs Ag、HBc Ab阳性模式(模式2)占13.30%(489/3 678),HBs Ag、HBe Ag、HBc Ab阳性模式(模式3)占11.56%(425/3 678)。不同主要血清学模式的HBs Ag阳性者性别、年龄、婚姻状况、文化程度、职业、体质指数及乙型肝炎家族史比较,差异均有统计学意义(P<0.05)。HBe Ag阳性者ALT、AST水平高于HBe Ag阴性者,GGT、ALB水平低于HBe Ag阴性者(P<0.05)。ALT水平≤2或>2倍参考范围上限者中,HBe Ag阳性与阴性者定期复查、药物治疗及因乙型肝炎住院治疗比例比较,差异均无统计学意义(P>0.05)。结论武威市社区HBs Ag阳性人群血清学以HBs Ag、HBe Ab、HBc Ab阳性模式为主,HBe Ag阳性与阴性者抗病毒药物治疗率均较低。
Objective To explore the seroepidemiological characteristics of HBs Ag-positive individuals from communities so as to provide the basic data for the field study in demonstration communities of hepatitis B prevention and treatment.Methods HBs Ag-positive individuals in this study were selected from the inhabitants underwent physical examination in demonstration communities of hepatitis B prevention and treatment and those with positive HBs Ag registered in community health service centers in Wuwei city from 2010 to 2014.Data of demographic characteristics and situation of anti-virus treatment of the subjects were collected by self-developed questionnaire.Serum samples were collected for HBV sero-biomarker test including HBs Ag,HBs Ab,HBe Ag,HBe Ab and HBc Ab,and biochemical indicator test including alanine aminotransferase（ ALT）,aspartate aminotransferase（ AST）,total bilirubin（ TBIL）,direct bilirubin（ DBIL）,gamma-glutamyl transpeptidase（ GGT）,albumin（ ALB） and alpha fetoprotein（ AFP）.Results A total of 3 678 individuals were tested positive for HBs Ag.Fourteen kinds of seroepidemiological modes were found,among which the mode with HBs Ag,HBe Ab and HBc Ab positive（ mode 1） accounted for 69.06%（ 2 540 /3 678）,the mode with HBs Ag and HBc Ab positive（ mode 2） accounted for 13.30%（ 489 /3 678）,and the mode with HBs Ag,HBe Ag and HBc Ab positive（ mode 3） accounted for 11.56%（ 425 /3 678） respectively.The gender,age,marital status,educational level,occupation,BMI,family hepatitis B infection history of HBs Ag-positive individuals with different main seroepidemiological modes were significantly different（ P〈0.05）.The levels of ALT and AST were significantly higher in HBe Ag-positive individuals than those in HBe Ag-negative,while the levels of GGT and ALB were lower than those in HBe Ag-negative（ P〈0.05）.No statistically significant differences were found in the ratios of regular check-up,anti-virus therapy and hospitalization due to hepatitis B between subjects in HBe Ag-positive group and those in HBe Ag-negative group among HBs Ag-positive individuals,no matter their ALT levels were less than or equal to or over 2 times of the upper limit value of reference range（ P〈0.05）.Conclusion Of the HBs Ag-positive individuals from communities in Wuwei city,the mode with HBs Ag,HBe Ab and HBc Ab positive is the major serological mode,the anti-virus therapy ratio is low in both individuals with HBe Ag-positive and those with HBe Ag-negative.
作者
王宇飞
王波
孙国栋
蒲中枢
闫永平
王安辉
WANG Yu -fei WANG Bo SUN Guo - dong PU Zhong - shu YAN Yong -ping WANG An - hui(Department of Epidemiology, Faculty of Preventive Medicine, the Fourth Military Medical University, Xi＇an 710032, China)
出处
《中国全科医学》
CAS
北大核心
2017年第2期191-195,共5页
Chinese General Practice
基金
"十二五"国家科技重大专项(2012ZX10004907)
国家自然科学基金面上项目(81072353)
陕西省社发公关项目(2016SF-086)
