【摘要】：目的了解社區(qū)乙型肝炎表面抗原(HBs Ag)陽(yáng)性人群血清流行病學(xué)特征,為乙型肝炎防治示范區(qū)現(xiàn)場(chǎng)研究提供基礎(chǔ)數(shù)據(jù)。方法選取武威市2010—2014年乙型肝炎防治示范區(qū)經(jīng)社區(qū)健康體檢篩選及各社區(qū)衛(wèi)生服務(wù)中心報(bào)告的HBs Ag陽(yáng)性者為研究對(duì)象。采用自制的調(diào)查問(wèn)卷收集研究對(duì)象人口學(xué)特征以及治療情況。采集研究對(duì)象靜脈血,檢測(cè)HBs Ag、乙型肝炎表面抗體(HBs Ab)、乙型肝炎e抗原(HBe Ag)、乙型肝炎e抗體(HBe Ab)、乙型肝炎核心抗體(HBc Ab)等血清學(xué)指標(biāo),以及丙氨酸氨基轉(zhuǎn)移酶(ALT)、天冬氨酸氨基轉(zhuǎn)移酶(AST)、總膽紅素(TBIL)、直接膽紅素(DBIL)、谷氨酸轉(zhuǎn)肽酶(GGT)、清蛋白(ALB)及甲胎蛋白(AFP)水平等生化指標(biāo)。結(jié)果本研究獲得由社區(qū)健康體檢篩選或社區(qū)衛(wèi)生服務(wù)中心報(bào)告的HBs Ag陽(yáng)性者3 678例。HBs Ag陽(yáng)性者血清學(xué)共有14種組合模式,HBs Ag、HBe Ab、HBc Ab陽(yáng)性模式(模式1)占69.06%(2 540/3 678),HBs Ag、HBc Ab陽(yáng)性模式(模式2)占13.30%(489/3 678),HBs Ag、HBe Ag、HBc Ab陽(yáng)性模式(模式3)占11.56%(425/3 678)。不同主要血清學(xué)模式的HBs Ag陽(yáng)性者性別、年齡、婚姻狀況、文化程度、職業(yè)、體質(zhì)指數(shù)及乙型肝炎家族史比較,差異均有統(tǒng)計(jì)學(xué)意義(P0.05)。HBe Ag陽(yáng)性者ALT、AST水平高于HBe Ag陰性者,GGT、ALB水平低于HBe Ag陰性者(P0.05)。ALT水平≤2或2倍參考范圍上限者中,HBe Ag陽(yáng)性與陰性者定期復(fù)查、藥物治療及因乙型肝炎住院治療比例比較,差異均無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論武威市社區(qū)HBs Ag陽(yáng)性人群血清學(xué)以HBs Ag、HBe Ab、HBc Ab陽(yáng)性模式為主,HBe Ag陽(yáng)性與陰性者抗病毒藥物治療率均較低。
[Abstract]:Objective to investigate the seroepidemiological characteristics of hepatitis B surface antigen (HBs Ag) positive population in community, and to provide basic data for the field study of hepatitis B prevention and control demonstration area. Methods the patients with HBs Ag positive from 2010 to 2014 were selected from the community health checkup screening and the community health service centers in the prevention and treatment demonstration area of hepatitis B in Wuwei city from 2010 to 2014. A self-made questionnaire was used to collect the demographic characteristics and treatment of the subjects. HBs Ag, hepatitis B surface antibody (HBs Ab), hepatitis B e antigen (HBe Ag), hepatitis B e antibody (HBe Ab), hepatitis B core antibody (HBc Ab) and other serological indexes were detected. And the biochemical indexes of alanine aminotransferase (ALT), aspartate aminotransferase (AST), total bilirubin (TBIL), direct bilirubin (DBIL), glutamate transpeptidase (GGT), albumin (ALB) and alpha-fetoprotein (AFP). Results in this study, 3 678 HBs Ag positive individuals who were screened by community health checkup or reported by community health service center had 14 combinations of. HBs Ag positive serological models, HBs Ag,HBe Ab,. HBc Ab positive pattern (mode 1) accounted for 69.06% (2540 / 3 678), HBs Ag,HBc Ab) positive pattern (mode 2) accounted for 13.30% (489 / 3 678), HBs Ag,HBe Ag,) HBc Ab positive pattern (mode 3) accounted for 11.56% (425 / 3678). Gender, age, marital status, education, occupation, body mass index and family history of hepatitis B were significantly different among HBs Ag positive patients with different serological patterns (P0.05). The level of AST was higher than that of HBe Ag negative, and the GGT,ALB level was lower than that of HBe Ag negative (P0.05). ALT level 鈮，

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