儿童乙型病毒性肝炎发病影响因素的研究

Influencial Factors on Occurrence of Hepatitis B Cases Among Children

目的探讨福建省<15岁儿童乙型病毒性肝炎(乙肝)发病的影响因素,为控制乙肝流行提供依据。方法根据2003年分层整群随机抽样进行儿童乙肝病毒表面抗原(HBsAg)携带率调查结果,随机抽取其中6个县(市、区),采用1∶2病例对照研究设计,对2005年以临床确诊为新发乙肝的儿童为病例,其同性别,同自然村或街道和年龄相差±2岁的、无血缘关系的、排除为乙肝的儿童为对照,使用统一调查表,进行问卷调查。资料编码量化后录入计算机,用SPSS13.0软件包进行条件Logistic单因素和多因素统计分析。结果儿童新发乙肝病例对照调查显示,单因素分析结果:乙肝疫苗接种史β=-2.259,本次发病前是否是HBsAg携带者β=-4.103,静脉输液史β=1.005,肌内注射、静脉注射史β=1.005,家庭内乙肝病人或HBsAg携带者β=1.366。多因素分析结果:乙肝疫苗接种史β=-4.131,本次发病前是否是HBsAg携带者β=-6.709。结论家庭内有乙肝病人或HBsAg携带者、有静脉输液史、有肌内或静脉注射史,对儿童乙肝的发病有危险作用;而有乙肝疫苗接种史、本次发病前不是HBsAg携带者,对儿童乙肝的发病有相对的保护作用。

Objective For providing testimony to control Hepatitis B （HB） in children aged less than 15 years old, we researched influencial factors on occurrence of Hepatitis B cases in children. Methods According to the investigation about HBsAg serological epidemiological sudy in Fujian in 2003 by stratified random duster sampling ,we selected six counties based on HBsAg（ ＋ ） rate as studying units, and designed the research with 1：2 case-control study. In research on occurrence of HB cases in children,we selected HB cases occurred in 2005 and aged less than 15 years as cases group,and selected children in same gender and same villige and age difference less than 2 years and no consanguini- ty relation as control objective. We enquire with unite questionnaire, and input database after coding. Then we conducted cox regression on single factor and multi-factors with SPSS 13.0. Results The case-control on occurrence of HB cases in children based on single factor showed as follow. Immunization history on HB vaccine β = - 2. 259, HBsAg（ ＋ ）beforeoccurrence of HB β= - 4. 103, intravenous transfution history β = 1. 005, intramuscular injection or intravenous injection history β = 1. 005. Intrafamiliar HB case or HBsAg（ ＋ ）case β = 1. 366. The case-control on occurrence of HB cases in children based on multi-factor showed as follow. Immunization history on HBV β = -4. 131, HBsAg（ ＋ ） before occurrence of HB β = - 6. 709. Conclusion Intrafamiliar Hepatitis B case or HBsAg （ ＋ ） case, intravenous transfution history, intramuscular injection or intravenous injection history are risk factors in occurrence of Hepatitis B cases. Immunization history on Hepatitis B vaccine, HBsAg（ - ）be- fore occurrence of Hepatitis B are protective factors in occurrence of Hepatitis B cases.