慢性乙型肝炎患者配偶乙型肝炎病毒感染状况调查和分析

The investigation and analysis of hepatitis B virus infection in spouses of chronic hepatitis B patients

目的 通过对慢性HBV感染者及其配偶HBV感染状况的调查和分析，评价婚后生活接触与慢性HBV感染之间的关系。方法选择婚前即为慢性HBV感染者、且婚后血清HBVDNA阳性的慢性HBV感染者，调查其配偶人群的家族史、献血史、输血史、吸毒史、健康体检史、婚检史、婚外性接触史及乙型肝炎疫苗接种史等，排除婚前已感染HBV或接种乙型肝炎疫苗的配偶。对68对入选夫妻双方进行HBV血清免疫学标志物和HBVDNA定量进行检测。入选的夫妻，结婚时间为平均12．5年（0．5～35年）。结果配偶人群中至少1项HBV血清标志物阳性者54例（79．4％），其中HBVDNA阳性者4例，研究对象的HBV感染后慢性化率为7．4％，与人群中成年人感染HBV后的慢性化率（5％～10％）相似；抗-HBs阳性者48例（88．9％），与健康人群接种乙型肝炎疫苗后抗-HBs的阳性率（85％～90％）相似。男性配偶中，至少1项HBV血清标志物阳性者22例（22／24），占91．7％；女性配偶32例（32／44），占72．7％，二者差异无统计学意义（X2=2．681，P〉0．05）。结论慢性乙型肝炎患者的配偶是否感染HBV与其结婚时间长短、性别及患者方的HBVDNA定量水平高低均无明显相关性。健康者与慢性HBV感染者婚配后HBV感染的机会增加，但转为慢性HBV感染的机会未见明显增加。

Objective To evaluate the influence of daily contact on HBV infection between hepatitis B virus carriers and their spouses by investigating the infection situation after marriage. Methods Premarital HBV carriers of serum HBV DNA positive were enrolled, family history, the history of blood donation, blood transfusion, drug abuse,physical examination, premarriage medical check, extramarital sex and hepatitis B vaccine were investigated in their spouses. Couples who were infected before marriage or vaccined with HBV vaccine were excluded. 68 couples were enrolled with an average marriage time of 12.5 years （0.5-35 years）, their HBV serum markers and quantitative were performed. Results In the 68 couples, 54（79.4%） spouses were serum HBV marker positive, of the 54 spouses, 4 were HBV DNA positive. The chronic rate of HBV infection in the spouses was 7.4%, and was similar to the rate in general population（5%-10% ）. 48（88.9% ） spouses were anti-HBs positive, the positive rate was similar to the rate in vaccinated population（85%-90%）. Male spouses with at least one HBV marker positive were 22 cases （22/24）, occupied 91.7%, female spouses were 32（32/44）, occupied 72.7%, there was no difference between the male and female spouses （Z2 = 2.681, P 〉 0.05）. Conclusions Whether HBV carriers＇ spouse infected with HBV is not correlated with marriage time, gender and HBV DNA level of carriers. HBV infection rate of the healthy people increases after marriage with HBV carriers, but the rate of chronic HBV infection is not increased obviouly.