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目的了解2007年浙江省丽水市不同人群病毒性乙型肝炎(乙肝)病毒(HBV)感染现状,分析感染危险因素。方法采用多阶段分层随机抽样方法,分城镇、农村点抽取常住居民为研究对象。进行入户调查,包括问卷调查、定性访谈以及采集血清标本,使用酶联免疫吸附试验(ELISA)法对血清标本进行检测。结果共完成调查3286人,男性1596人,女性1690人。平均年龄(43.70±0.68)岁,最大年龄96岁,最小1岁。全人群HBV携带标化率为10.19%,男性感染率为12.36%,女性为9.03%,男女差异无统计学意义(χ2=0.10,P=0.750);1～岁、6～岁、15～岁、61～岁4个年龄组阳性率分别为0.45%、3.74%、15.52%、6.53%。乙肝病毒表面抗体(抗-HBs)阳性率1～岁组人群最高,为51.23%,6～岁组最低,为36.64%。接种乙肝疫苗者与未接种的HBV感染率分别是1.55%和10.39%。小学以下文化程度的人群HBV感染率(9.65%)与初中以上文化程度的人群(3.87%)相比为高(χ2=24.77,P=0.000)。共用牙刷、共用剃须刀、创伤性美容史、输血、有偿献血等都是感染HBV的高危险因素。结论丽水市居民HBV携带率仍偏高。接种乙肝疫苗能明显降低HBsAg携带率,提高抗-HBs阳性率。针对危险因素采取干预措施是降低人群乙肝感染的有效方法。
Objective To understand the status of viral hepatitis B (HBV) infection in different populations in Lishui City, Zhejiang Province in 2007 and analyze the risk factors of infection. Methods A multi-stage stratified random sampling method was used to study permanent residents in urban and rural areas. Household surveys, including questionnaires, qualitative interviews and serum samples were collected, and serum samples were detected by enzyme-linked immunosorbent assay (ELISA). Results A total of 3286 people were surveyed, including 1596 males and 1690 females. The average age (43.70 ± 0.68) years old, the maximum age of 96 years old, minimum 1 year old. The rate of standardization of HBV in the whole population was 10.19%, and the infection rate was 12.36% in males and 9.03% in females. There was no significant difference between males and females (χ2 = 0.10, P = 0.750); 1 ~ 6 years old, 15 ~ , The positive rates of 61 ~ 4 years old group were 0.45%, 3.74%, 15.52%, 6.53% respectively. The positive rate of hepatitis B virus surface antibody (anti-HBs) was highest in the population aged 1 ~ 51.23%, the lowest in 6 ~ 36.64%. Infection with hepatitis B vaccine and unvaccinated HBV infection rates were 1.55% and 10.39%. The prevalence of HBV infection (9.65%) was lower in primary education than in junior high school education (3.87%) (χ2 = 24.77, P = 0.000). Shared toothbrush, shared razor, traumatic beauty history, blood transfusion, paid blood donation are all high risk factors for HBV infection. Conclusion HBV carrier rate of residents in Lishui City is still high. Inoculation of hepatitis B vaccine can significantly reduce the carrier rate of HBsAg and improve the anti-HBs positive rate. Interventions for risk factors are effective ways to reduce hepatitis B infection in the population.