选择手术中乙型肝炎病毒传染源筛查指标

Choose Marks of Screening HBV Infective Source During Surgical Operation

目的选择手术中乙型肝炎病毒(HBV)传染源筛查指标。方法以手术中HBV感染阈值、传染源和外科医生易感性为基础,选择HBV传染源筛查指标。结果乙型肝炎疫苗免疫前,HBsAg阳性者和HBeAg阳性者中传染源分别为19.2%和83.9%,阴性者为0和3.2%;以HBsAg筛查传染源的灵敏度显著高于HBeAg,而特异度显著低于HBeAg;乙型肝炎疫苗免疫后,HBsAg阳性者和HBeAg阳性者中传染源分别为0.6%和3.2%,阴性者均为0;HBeAg为指标筛查传染源的灵敏度与HBsAg相同,但特异度显著高于HBsAg。结论乙型肝炎疫苗预防前筛查手术中HBV传染源应以HBsAg为指标,而其后应以HBeAg为指标。

OBJECTIVE To choose the marks of screening HBV infective source during surgical operation. METHODS On the basis of the HBV infective threshold value, HBV infective source and HBV susceptibility among the surgeons, to choose the marks of screening HBV infective source during surgical operation. RESULTS Before the immunization of surgeons against HBV, the ratio of HBV infective source between HBsAg positive and HBeAg positive carriers was 19. 2% and 83. 9%, respectively. That of HBsAg negative and HBeAg negative carriers was 0 and 3.2 %. The sensitivity of screening HBV infective source with HBsAg acting as mark was much higher than HBeAg. The specificity was lower than HBeAg. After the immunization of surgeons against HBV, the ratio of HBV infective source between HBsAg positive and HBeAg positive carriers was 0.6% and 3.2%, respectively. None of the negative one was HBV infective source during surgical operation. The sensitivity of screening HBV infective source with HBeAg acting as mark was the same as HBsAg. But the specificity was remarkably higher than HBsAg. CONCLUSIONS Before the immunization of surgeons against HBV, HBsAg acting as the screening mark of HBV infective source during surgical operation is more suitable. After that HBeAg is more suitable.