北京市崇文区1997-2006年病毒性肝炎流行病学分析及防控措施探讨

Epidemiological characteristics and prevention strategies of viral hepatitis in Chongwen District of Beijing during 1997-2006

目的为了解病毒性肝炎流行特征，为制定和调整防控策略提供科学依据。方法采用描述流行病学分析方法，对崇文区1997-2006年间1121例病毒性肝炎病例进行分析，率的比较采用卡方检验。结果10年间发病1121例，呈逐年下降趋势，年平均发病率为27．10／10万，其中乙型肝炎（简称乙肝）年均发病率最高（13．90／10万），丙型肝炎（简称丙肝）最低（1．38／10万）。从病原学分型看，乙肝构成比最高（575例，51．29％），丙肝最低（57例，5．08％）；甲型肝炎（简称甲肝）、未分型、乙肝均呈不同程度的下降趋势，丙肝和戊型肝炎（简称戊肝）呈平稳上升的趋势；甲肝和未分型都以冬春季为主，乙肝、丙肝和戊肝无明显的季节性；男女发病差别有统计学意义（χ^2=188．39，P〈0．001）；各职业均有发病，工人（306例，27．3％）和干部（209例，18．64％）为主；发病集中在20—49岁（749例，66．82％）；经血液传播发病强度（7．64／10万）明显高于经粪、口途径传播（3．02／10万）（χ^2=5．09，P〈0．01）。结论进一步提高群众防病和主动接受免疫服务意识，在做好甲肝乙肝疫苗常规免疫的基础上，扩大免疫接种对象范围，加强重点人群免疫接种工作。加强血液、血液制品、医源性感染管理工作，遏制病毒性肝炎的发病。

Objective To understand the epidemiological features of viral hepatitis, and providea scientific evidence for developing strategies for prevention and control. Methods Through descriptive epidemiological methodology, the epidemiological characteristics of 1121 viral hepatitis cases in Chongwen District （1997 -2006） were studied. χ^2-test was used in ratio comparison. Results There were 1121 viral hepatitis cases occurring in the past decade, and the incidence rate was declining by year with the average of 27. 10/100 000. Of which, the incidence rate of viral hepatitis B was the highest （13.90/100 000）, viral hepatitis C （1.38/100 000） was the lowest. The proportion of viral hepatitis B was the highest （575, 51.29% ） and viral hepatitis C （57,5.08%） was the lowest. The incidence of viral hepatitis A, B and notyping was declining year by year, while viral hepatitis C and E was climbing. Most viral hepatitis A and E cases occurred in Spring and Winter, and the difference of incidence rate between male and female was observed （χ^2= 188. 39 ,P 〈 0. 001）. The findings also showed that viral hepatitis might occur in all kind of occupation, but most were workers （306,27.3%） and officers（209,18.64% ）. For the age distribution, 20 -49 years old group took the majority （749, 66. 82% ） ; and for the transmission route, blood transfusion （7.64/100 000） was significantly higher than fecal-oral route （ 3.02/100 000 ） （ χ^2 = 5.09, P 〈 0. 01 ）. Conclusion It is necessary to raise and increase the public awareness for viral hepatitis prevention and control, and enhance immunization. Moreover, effective measures should be taken to the safety of blood and blood products, and to prevent nosocomial infection.