北京市密云县病毒性肝炎病原学分型诊断调查

Etiologic typing diagnosis for viral hepatitis in Miyun county,Beijing

目的了解急性病毒性肝炎的分型诊断与疫情报告之间的差距,准确掌握北京市密云县各型病毒性肝炎发病情况的基线资料,为今后制定科学的防治策略提供科学依据。方法收集2005～2008年医疗机构网络直报的急性病毒性肝炎发病病例,对其进行流行病学调查或血清学检测。结果2005～2008年网报急性病毒性肝炎总例数为455例,核实确诊305例,符合率为67.03%。305例中甲型病毒性肝炎3例,占急性病毒性肝炎的0.98%;乙型病毒性肝炎161例,占52.79%;丙型病毒性肝炎27例,占8.85%;丁型病毒性肝炎1例,占0.33%,戊型病毒性肝炎58例,占19.02%;未分型肝炎55例,占18.03%。2005～2008年,密云县急性病毒性肝炎发病病例以乙型为主,甲型比例很小,但戊型肝炎的发病不容忽视。结论乙型肝炎、戊型肝炎应为当前病毒性肝炎防治重点;应进一步规范临床病毒性肝炎的诊断,同时继续定期开展病毒性肝炎的血清学监测。

Objective To evaluate difference between etiologic typing diagnosis for acute viral hepatitis by laboratory tests and their notification and learn accurate baseline information of incidence of various types of viral hepatitis in Miyun county,Beijing to provide scientific evidence for future development of their prevention and treatment strategy.Methods Records for cases with acute viral hepatitis were collected reported from medical care institutions directly via the Notification Network for Communicable Diseases during 2005 to 2008,and epidemiological survey or serological testing were performed for them.Results A total of 455 cases of acute viral hepatitis were directly reported via the Network during 2005 to 2008,305 of them confirmed by laboratory testing,with an agreement of 67.03 percent.Among 305 cases,three infected with hepatitis A（HA）（0.98%）,161 with HB（52.79%）,27 with HC（8.85%）,one with HD（0.33%）,58 with HE（19.02%）,and 55 unclassified（18.03%）.Conclusion During 2005 to 2008 in Miyun county,viral hepatitis reported were HB mainly,HA accounted for a very small proportion,but HE could not be ignored.Currently,prevention for HB and HE should be prioritized in Miyun.Clinical diagnosis for viral hepatitis should be standardized further,and regular serological surveillance for viral hepatitis should be continuously implemented,as well.