云南省乙型肝炎病毒感染危险因素Logistic回归模型分析

Investigation on Risk Factors of the Hepatitis B Virus lnfection by Logitstic Regression in Yunnan Province

目的分析云南省乙型肝炎(乙肝)病毒(Hepatitis B Virus,HBV)感染的危险因素和家庭聚集性,为制定乙肝预防和控制策略提供参考。方法利用2006年全国人群乙肝血清流行病学调查资料分析HBV感染状况,建立Logistic回归模型分析HBV感染相关危险因素,建立混合线性模型分析HBV感染的家庭聚集性。结果 HBV感染率和乙肝病毒表面抗原(HBV Surface Antigen,HBsAg)阳性率,均是少数民族聚居地区高于非少数民族地区(2=134.389,P=0.000;2=26.019,P=0.000)。经单因素和多因素Logistic回归模型分析发现,少数民族、长期生活在一起的人中有HBsAg阳性、未接种乙肝疫苗等7个因素,是HBV感染的危险因素。HBV感染呈明显的家庭聚集性(Waldz=29.496,P=0.000),HBV感染家庭聚集率为27.96%。其中城市HBV感染未呈现家庭聚集性(Waldz=1.506,P=0.132),农村HBV感染呈家庭聚集性(Waldz=2.232,P=0.026)。四年后随访64个HBsAg阳性者的家庭成员215人,新发现HBsAg阳性5例。结论加强对少数民族地区和农村地区HBV感染及HBV感染者家庭成员的预防和控制,是云南省预防控制乙肝的关键。

Objective To investigate the risk factors of hepatitis B virus （HBV） infection and the familial clustering risk factors associated with HBV infection, and to provide evidence for the disease control in Yunnan province. Methods A logistic regression model was used to analyze the risk factors of the HBV ihfection and a muhilevel model was used to analyze the familial clustering risk factors associated with HBV infection in Yunnan province. The data collected from the serological epidemiology investigation of the HBV infection in China in 2006. Result The results showed that the infection rate of HBV and the HBV surface antigen （HBsAg）positive rate in minorities areas were higher than in the un-minorities areas （χ2=134.389, P=0.000 ;χ2=26.019, P=0.000）. The impact factors includ the minorities, family members of positive HBV surface antigen （HBsAg）, no vaccination history of hepatitis B. The rate of familial clustering of HBV was 27.96 % and the trend of familial clustering of HBV was showed in Yunnan province （Wald z=29.496, P=0.000）, especially in rural areas （Wald z=2.232, P=0.026）and not in urban areas （Wald z=1.506, P=0.132）. Five positive HBsAg persons were detected among the 215 persons from 64 families whose member was positive HBsAg being found four years ago. Conclusion It is the key measures to strengthen the prevention and control for HBV infected person and members of HBV infected families in the rural and minority areas.