西安市1990—2007年甲型病毒性肝炎报告发病趋势及其影响因素

Epidemic Tendency and Influencing Factors of Hepatitis A in Xi'an City during 1990— 2007

目的分析西安市甲型肝炎(甲肝)发病趋势和流行因素,为制定防制措施提供依据。方法根据1990—2007年西安市疫情年报、专题调查和分析;应用趋势检验、周期性检验和χ2检验等方法处理数据,并进行流行病学分析。结果18年中报告甲肝31631例,年报告病例波动在170～6556例间(均数=1757.3例/a),占同期病毒性肝炎的15.82%,年构成波动在1.55%～43.89%(均数=15.82%),经χ2检验,差异有统计学意义(χ2=22418.6548,P<0.01);与全国甲肝发病率比较相关系数(rs)为0.9443,显示高度正相关,发病率呈明显下降趋势,游程检验差异有统计学意义(P<0.01),18年中可见间隔四五年的4个周期,周期性检验差异有统计学意义(P<0.01)。不同年代季节分布差异有统计学意义(χ2=88.9328,P<0.01),表现春、夏季峰消失。年龄组分布差异亦有统计学意义(χ2=58.2380,P<0.01);男女比为1.51∶1,但差异无统计学意义(χ2=5.509,P>0.05);职业构成差异有统计学意义(χ2=58.2380,υ=6,P<0.01)。结论西安市甲肝发病已属低流行区,但学校和托幼机构仍是控制重点,加强疫苗接种,提高监测质量是目前主要措施。

[ Objective ] To analyze the Incidence trends and prevalence factors of Hepatitis A in Xi＇an City, and provide evidence for developing control measures. [ Methods ] Based on the epidemic annual report, thematic investigation and analysis; trend test, periodic inspection and X2 test were adopted to deal with data, and epidemiological analysis was conducted. [ Results ] A total of 31 631 cases of Hepatitis A were reported with an annual fluctuation of 170 - 6556 cases （ Mean = 1757.3 cases / year}, occupied 15.82% of virus hepatitis in the same period with a constitute fluctuation of 1.55% -43.89% （ Mean = 15.82% ）, the difference was significant byX2 test （ X2 = 22418. 6548, P 〈 0. 01 ） ; comparing with the national incidence of hepatitis A, correlation coefficient （ rs）0.9443 showed a high positive correlation, morbidity was a clear downward trend, the difference was significant by runs test （ P 〈0. 01 ）. 4 cycles could be identified every 4 or 5 years during the whole 18 years, the difference was significant by period test （ P 〈 0. 01 ）. The difference of seasonal distribution was significant （ X2 = 88. 9328, P 〈 0. 01 ）, with disappeared spring and summer peaks. The difference of distribution of age groups was significant（ X2 =58. 2380,P 〈0. 01 ） ; Male to female ratio was 1.51 ： 1, but the difference was not significant （ X2 = 5. 509, P 〉 0.05 ）; difference of occupational constitute was significant （ X2 = 58.2380,v = 6, P 〈 0. 01 ）. [ Conclusion] Xi＇an is an endemic area with low incidence of hepatitis A. However, schools and childcare agencies are still critical control points; strengthening vaccination, improving quality monitoring are major measures at present.