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目的研究天津市乙型病毒性肝炎(HB)的现患状况,探讨以社区为基础调查核实患病率真实性的新研究方法,为改进HB的管理及控制提供依据。方法采取多阶段整群抽样方法,以天津市行政社区为基础抽样选定12个监测点社区,用多种途径对监测点社区的HB病例进行多方搜集、核实和个案流行病学调查,分析评价调查数据。共搜集病例1 839例,核实成功1 267例,核实差额原因。结果 2012年HB标化现患病率为231.30/10万,男性患病例数多于女性。现患病例年龄中位数为48岁,首次发病年龄中位数为38岁。男性“大三阳”及“小三阳”患者均多于女性。不同年龄组“大三阳”、“小三阳”及HB病毒表面抗原和抗HB病毒核心抗原抗体阳性分布不同(P<0.01)。logistic单因素分析,药物治疗、戒酒及保持乐观情绪与现患病例的丙氨酸转氨酶(ALT)水平升高明显相关(OR值分别为9.86、0.16和0.29,P<0.01)。结论以社区为基础对HB现患病例进行核实、调查和管理是科学、有效的新防控方法,值得推广。
Objective To study the prevalence of hepatitis B in Tianjin and to explore a new community-based research to verify the authenticity of the prevalence and provide a basis for improving the management and control of HB. Methods A multistage cluster sampling method was used to select 12 monitoring communities based on the administrative community in Tianjin. Multiple ways were used to collect, verify and case-by-case epidemiological investigation of HB cases in community of monitoring sites. survey data. A total of 1 839 cases were collected and 1 267 cases were verified successfully to verify the reason for the difference. Results The prevalence of HB standardization in 2012 was 231.30 / 100,000, with more cases of males than females. The median age at diagnosis was 48 years and the median age at onset was 38 years. Male “Sanyang ” and “Sanyang ” patients are more than women. The positive distribution of HBsAg and HBcAg in different age groups were different (P <0.01). Logistic univariate analysis, medication, alcohol abstinence and optimism were significantly associated with increased ALT levels (OR = 9.86, 0.16 and 0.29, respectively, P <0.01). Conclusions Community-based verification, investigation and management of current cases of HB are a new scientific and effective method of prevention and control and worthy of promotion.