本文選題：乙型肝炎 + 血清流行病學(xué)��； 參考：《蘇州大學(xué)》2008年碩士論文

【摘要】： 目的:了解蘇州市居民乙型肝炎病毒(HBV)的感染現(xiàn)狀及流行特征;了解蘇州市不同地區(qū)、不同人群乙型肝炎(乙肝)疫苗免疫接種情況;評價乙肝疫苗納入兒童計劃免疫策略后乙肝防制的效果,為政府部門進一步制定乙肝的防制措施提供科學(xué)依據(jù)。 方法:(1)抽樣方法:采用多級隨機抽樣法。在蘇州市7區(qū)5縣(市)范圍內(nèi),抽取1個區(qū)和1個縣(市),抽到的區(qū)作為城市調(diào)查點,抽到的縣(市)作為農(nóng)村調(diào)查點;在抽到的區(qū)、縣(市)中分別抽取3個街道或2個鄉(xiāng)鎮(zhèn);在每個抽到的街道、鄉(xiāng)鎮(zhèn)隨機抽取1個居民委員會或1個村民委員會,作為調(diào)查現(xiàn)場;在每個調(diào)查現(xiàn)場按照1～4歲、5～14歲、15～59歲年齡組,分別以村莊、個體、家庭為單位,進行抽樣,抽取足夠的調(diào)查對象。(2)調(diào)查方法:對每個調(diào)查對象按統(tǒng)一調(diào)查表進行詢問調(diào)查,同時采集靜脈血,分離血清,低溫保存,檢測相關(guān)指標(biāo)。(3)檢測方法:用酶聯(lián)免疫法(ELISA)檢測乙肝病毒表面抗原(HBsAg)、乙肝病毒表面抗體(抗-HBs)和乙肝病毒核心抗體(抗-HBc)。檢測在中國疾病預(yù)防控制中心病毒所進行,檢測試劑采用廈門英科新創(chuàng)生物技術(shù)有限公司生產(chǎn)的ELISA試劑。(4)統(tǒng)計方法:所有資料錄入EpiData3.1數(shù)據(jù)庫后,用SPSS11.5軟件進行統(tǒng)計處理和分析。 結(jié)果:(1)人口學(xué)特征:調(diào)查對象涉及到不同地區(qū)、年齡、性別、文化程度、職業(yè)、婚姻等。其中城鄉(xiāng)人口比為1:1.01;1～4歲、5～14歲、15～59歲年齡構(gòu)成比分別為19.23%、29.75%和51.02%;男女性別比為1:1.06。(2)乙肝疫苗接種情況:蘇州市居民平均乙肝疫苗接種率為50.64%;城市與農(nóng)村人群乙肝疫苗接種率無顯著性差異;15歲～以下兒童組乙肝疫苗接種率(75.58%)明顯高于15歲～以上青少年成人組(26.71%)。(3)HBV感染標(biāo)志血清流行病學(xué)特征:人群中HBsAg陽性率為5.45%(72/1321),抗-HBs陽性率為58.29%(770/1321),抗-HBc陽性率為23.69%(313/1321),HBV感染率為39.89%(527/1321)。城市與農(nóng)村人群HBsAg陽性率無顯著性差異;15歲~以下兒童組HBsAg陽性率明顯低于15歲～以上青少年成人組,其中兒童組中1～4歲抗-HBs陽性率高于5～14歲組;人群中HBsAg陽性率男性高于女性,但15歲～以下人群性別間無顯著性差異。 結(jié)論:蘇州市乙肝疫苗納入兒童計劃免疫后效果顯著,有效降低了人群HBsAg攜帶率和HBV感染率,已經(jīng)從高流行地區(qū)進入中流行地區(qū)(8%HBsAg陽性率≥2%);其中1992年乙肝疫苗納入兒童計劃免疫管理以后出生的15歲以下兒童HBsAg陽性率發(fā)生顯著下降,特別是5歲以下人群下降幅度更加明顯,初步實現(xiàn)WHO西太區(qū)制定的5歲以下兒童HBsAg陽性率控制在1%以下的目標(biāo);而15歲～以上青少年成人組HBsAg陽性率變化不明顯;說明實施大規(guī)模乙肝疫苗接種是控制HBV感染最有效的措施,提示今后在重點做好計劃免疫人群乙肝疫苗接種的同時,還應(yīng)提高成人乙肝疫苗接種免疫。
[Abstract]:Objective: to understand the infection status and epidemic characteristics of hepatitis B virus (HBV) in Suzhou residents, to understand the immunization of hepatitis B vaccine in different regions and different populations in Suzhou, and to evaluate the effect of hepatitis B prevention after the hepatitis B vaccine included in the planned immunization strategy of children, and to provide the government departments to further develop the prevention measures for hepatitis B. Scientific basis.
Methods: (1) sampling method: using the multilevel random sampling method, 1 districts and 1 counties (cities) were extracted from 5 counties (cities) of 7 District of Suzhou, and the areas were taken as urban investigation points, and the counties (cities) were taken as rural investigation points; 3 streets or 2 townships were extracted from the counties (cities), and 1 townships were randomly selected in each street. The residents' committee or 1 villagers' committees were used as the investigation site, and at the site of each survey, the samples were sampled at the age of 1~4, 5~14, and 15~59 years old, taking the villages, individuals and families as units respectively. (2) the investigation method: every investigation object was investigated according to the unified questionnaire, and the venous blood was collected at the same time. Serum, cryopreservation and related indexes were detected. (3) detection methods: HBV surface antigen (HBsAg), HBV surface antibody (anti -HBs) and hepatitis B virus core antibody (anti -HBc) were detected by enzyme linked immunosorbent assay (ELISA). The detection reagent was carried out in China Center for Disease Control and Prevention (CDC), and the detection reagent was used in Xiamen British new creation biological technology. The ELISA reagent produced by limited company. (4) statistical method: after all data are input into EpiData3.1 database, SPSS11.5 software is used for statistical processing and analysis.
Results: (1) demographic characteristics: the respondents were involved in different areas, age, sex, education, occupation, marriage and so on. The ratio of urban and rural population was 1:1.01, 1~4 years old, 5~14 years old and 15~59 years old, respectively 19.23%, 29.75% and 51.02%; the sex ratio of men and women was 1:1.06. (2) hepatitis B vaccination: the average hepatitis B vaccine of Suzhou residents The inoculation rate was 50.64%, and there was no significant difference in the rate of hepatitis B vaccination among urban and rural population, and the rate of hepatitis B vaccination in children under 15 years to below (75.58%) was significantly higher than that of 15 years old adults (26.71%). (3) the sero epidemiological characteristics of HBV infection markers: the positive rate of HBsAg in the population was 5.45% (72/1321), and the positive rate of anti -HBs was 58.29% (770/ 1321) the positive rate of anti -HBc was 23.69% (313/1321), and the infection rate of HBV was 39.89% (527/1321). There was no significant difference in the positive rate of HBsAg in urban and rural population; the positive rate of HBsAg in children under 15 years old was significantly lower than that of adolescents aged 15 years and above, of which the positive rate of 1~4 years in children was higher than that of 5~14 years, and the positive rate of HBsAg in the population was male. It was higher than that of women, but there was no significant difference in gender between 15 and below.
Conclusion: the effect of hepatitis B vaccine in Suzhou was significant after children's planned immunization. The rate of HBsAg and HBV infection were effectively reduced. The positive rate of 8%HBsAg was more than 2% in the high epidemic area. In 1992, the positive rate of HBsAg in children under 15 years of age after hepatitis B vaccine was brought into children's planned immunization management. In particular, the decline of the population under 5 years of age was more obvious, and the HBsAg positive rate of children under 5 years of age under the age of WHO was controlled under 1%, while the positive rate of HBsAg in the young adults aged 15 years and above was not obvious; it indicated that the most effective measures to control HBV infection were the most effective measures to control HBV infection. In the future, we should focus on immunization with hepatitis B vaccine, and we should also improve adult hepatitis B vaccination.
【學(xué)位授予單位】：蘇州大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2008
【分類號】：R181.3

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