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目的了解0~7岁儿童乙型肝炎病毒(HBV)血清学模式及其分布特征。方法收集2013年1月至12月重庆医科大学附属儿童医院0~7岁就诊儿童HBV血清学标志物检测结果及HBV表面抗原(HBs Ag)(+)患儿家族史,对其资料进行回顾性分析。结果共检出17种血清学模式,各模式在不同年龄组检出率不同。HBs Ag总检出率为0.32%,各年龄组HBs Ag检出率差异无统计学意义。模式10“HBV表面抗体(抗-HBs)(+)、HBV核心抗体(抗-HBc)(+)”、模式11“抗-HBs(+)、HBV e抗原(HBe Ag)(+)、抗-HBc(+)”、模式12“抗-HBs(+)、HBV e抗体(抗-HBe)(+)、抗-HBc(+)”、模式16“抗-HBc(+)”及模式17“抗-HBe(+)、抗-HBc(+)”在0~28 d组、>28 d至1岁组的检出率均明显高于其余各年龄组(P<0.05)。HBV前S1抗原(Pre S1-Ag)(+)见于5种血清学模式,以“HBs Ag(+)、HBe Ag(+)”模式检出率最高(100%),其次为“HBs Ag(+)、HBe Ag(+)、抗-HBc(+)”模式(80.77%)。Pre S1-Ag在HBe Ag(+)组中的检出率为80.72%,明显高于HBe Ag(-)组(25.00%),两组检出率比较,差异具有统计学意义(χ2=14.083,P=0.000)。结论重庆医科大学附属儿童医院0~7岁儿童HBs Ag阳性率随年龄增长无明显变化,而HBV血清学模式分布与年龄相关。Pre S1-Ag与HBe Ag具有相关性,二者联合检测能更好地反映HBV复制情况,具有重要临床价值。
Objective To understand the serological patterns and distribution of hepatitis B virus (HBV) in children aged 0-7 years. Methods The serological markers of HBV seropositive children aged 0-7 years and children with HBV surface antigen (HBs Ag) (+) were collected from Children’s Hospital of Chongqing Medical University from January to December 2013. The data were retrospectively analyzed analysis. Results A total of 17 serological patterns were detected, with different detection rates in different age groups. The total detection rate of HBs Ag was 0.32%. There was no significant difference in the detection rate of HBsAg among all age groups. Pattern 10 “HBV surface antibody (anti-HBs) (+), HBV core antibody (anti-HBc) (+)”, pattern 11 “anti-HBs (+), HBV e antigen (HBe Ag) Anti-HBc (+), anti-HBc (+), anti-HBc (+), anti-HBc (+) ”And pattern 17“ anti-HBe (+) and anti-HBc (+) ”were significantly higher in the 0-28 d group than the 28-d to 1-year old group Group (P <0.05). Pre S1-Ag (+) was found in 5 serological models with the highest detection rate (100%) in “HBsAg (+) and HBeAg (+)” mode, followed by “ HBs Ag (+), HBe Ag (+) and anti-HBc (+) ”mode (80.77%). The detection rate of Pre S1-Ag in HBeAg (+) group was 80.72%, which was significantly higher than that in HBe Ag (-) group (25.00%), the difference was statistically significant (χ2 = 14.083 , P = 0.000). Conclusion The positive rate of HBsAg in children aged 0-7 years in Children’s Hospital Affiliated to Chongqing Medical University has no significant change with age, while the distribution of HBV serology is age-related. Pre S1-Ag is associated with HBeAg, and the combined detection of these two factors can better reflect the HBV replication, which has important clinical value.