【摘要】： 目的:了解張家港市人群乙型肝炎病毒(HBV)的感染現(xiàn)狀及流行特征;了解張家港市不同地區(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免疫策略后的效果,為政府部門進(jìn)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。在張家港市9鎮(zhèn)范圍內(nèi)抽取2個鎮(zhèn);在每個抽到的鎮(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(jìn)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(jìn)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(jìn)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SPSS13.0軟件進(jìn)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1～4歲、5～14歲、15～59歲年齡構(gòu)成比分別為19.61%、30.32%和50.08%;男女性別比為1:1.03。(2)乙肝疫苗接種情況:張家港市人群平均乙肝疫苗接種率為50.83%;不同地區(qū)人群乙肝疫苗接種率無顯著性差異;15歲以下人群組乙肝疫苗接種率(99.09%)明顯高于15歲以上人群組(2.71%)。(3)HBV感染標(biāo)志血清流行病學(xué)特征:人群中HBsAg陽性率為5.73%(38/663),抗-HBs陽性率為52.19%(346/663),抗-HBc陽性率為24.43%(162/663),HBV感染率為32.43%(215/663)。不同地區(qū)人群HBsAg陽性率無顯著性差異;15歲以下人群組HBsAg陽性率明顯低于15歲以上人群組,其中1～4歲人群組抗-HBs陽性率和5～14歲組無顯著性差異;人群中HBsAg陽性率男性和女性無顯著性差異。 結(jié)論:張家港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(jìn)入中流行地區(qū)(2%≤HBsAg陽性率8%);其中1992年乙肝疫苗納入兒童計劃免疫管理以后出生的15歲以下人群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,實現(xiàn)WHO西太區(qū)制定的5歲以下人群HBsAg陽性率控制在2%以下的目標(biāo);而20歲以上人群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)提高成人乙肝疫苗免疫接種。
[Abstract]:Objective: to understand the present situation and epidemic characteristics of hepatitis B virus (HBV) infection in Zhangjiagang population, and to understand the vaccination status of hepatitis B vaccine in different areas and different populations in Zhangjiagang city. To evaluate the effect of hepatitis B vaccine in children's immunization strategy, and to provide scientific basis for government departments to make further prevention and control measures of hepatitis B. Methods: (1) sampling method: multistage random sampling method was used. In Zhangjiagang City, 2 towns were selected within the scope of 9 towns, 1 resident committee or 1 villagers committee was randomly selected from each of the selected towns as the investigation site. At each site, samples were taken from villages, individuals and households according to the age groups of 1 to 4 years, 5 to 14 years, 15 to 59 years of age, respectively. (2) investigation methods: each of the subjects was investigated according to the unified questionnaire, and the venous blood was collected at the same time, the serum was separated, and the hypothermia was preserved. (3) Detection methods: (ELISA) was used to detect (HBsAg), hepatitis B virus surface antibody (anti HBs) and hepatitis B virus core antibody (anti HBc).) by enzyme linked immunosorbent assay (Elisa). The test was carried out at the China Center for Disease Control and Prevention (CDC), and the reagents were ELISA reagents produced by Xiamen Inco New Biotechnology Co., Ltd. (4) Statistical methods: all the data were entered into the EpiData3.1 database, Use SPSS13.0 software for statistical processing and analysis. Results: (1) demographic characteristics: subjects involved in different regions, age, sex, education, occupation, marriage and so on. Among them, the age composition ratios of 1, 4, 5, 15 and 59 years old were 19.61% and 50.08%, respectively. The sex ratio of male and female was 1: 1.03. (2) the vaccination rate of hepatitis B vaccine in Zhangjiagang city was 50.83%, but there was no significant difference in the coverage rate of hepatitis B vaccine among different population in Zhangjiagang city. The hepatitis B vaccination rate (99.09%) in the population under 15 years old was significantly higher than that in the group over 15 years old (2.71%). (3). The positive rate of HBsAg was 5.73% (38 / 663). The positive rate of anti-HBs was 52.19% (346 / 663) and the positive rate of anti-HBc was 24.43% (162 / 663), HBV infection rate was 32.43% (215 / 663). There was no significant difference in the positive rate of HBsAg among different population groups, the positive rate of HBsAg in the group of people under 15 years old was significantly lower than that in the group of people over 15 years old, and there was no significant difference in the positive rate of anti-HBs in the group of 1 or 4 years old and the group of 5 ~ 14 years old. There was no significant difference in HBsAg positive rate between male and female. Conclusion: the effect of hepatitis B vaccine in Zhangjiagang city is remarkable after it is included in the children's plan immunization, and it can effectively reduce the carrying rate of HBsAg and the infection rate of HBV in the population. It has already entered the middle epidemic area from the high epidemic area (2% 鈮，

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