密云县食品及公共场所从业人员健康检查中丙氨酸氨基转移酶的结果分析

Analysis on the ALT examination results of the employees working in food and public places of Miyun County

目的了解北京市密云县近几年来食品及公共卫生场所从业人员丙氨酸氨基转移酶(ALT)不合格情况。方法对2006—2011年间食品及公共场所从业人员健康检查结果中的ALT进行了分析,采用紫外-乳酸脱氢酶法检测ALT活力,对于ALT>40 U/L样本利用酶联免疫吸附测定(ELISA)法进行甲(A)型肝炎、戊型肝炎复查。结果 2006—2011年,食品及公共卫生场所从业人员参加健康检查人员共计136 913人,总异常率为3.1%,ALT的异常率由2006年的1.86%上升到2009年的3.91%,呈现逐年上升的趋势,此后2 a有些回落,每年ALT>40 U/L的样本甲(A)型肝炎、戊型肝炎的检出率在0.1%～0.5%之间。对2010和2011两年间的检查人员进行进一步的分析,结果发现,≤20岁年龄组ALT异常率最低为2.17%,其余呈现由低年龄组向高年龄组逐一降低的趋势,由4.13%下降到2.98%;不合格者主要集中在21～40岁的人群,占总异常例数的67.1%;男性ALT异常检出率远高于女性,差异有统计学意义(χ2=767.262,P<0.01)。结论该县两行业健康检查人群ALT的异常检出率在不同性别,不同年龄组间有显著差异,有极低的比例为患有甲型肝炎、戊型肝炎所致,绝大多数是由于一些非特异性因素影响导致的ALT单项不合格。

[Objective] To understand the situation of unqualified ALT of employees working in food and public places in Miyun County.[Methods]The examination results of the unqualified alanine transaminase（ALT） of the employees working in food and public health place from 2006 to 2011 in Miyun county were analyzed.Ultraviolet lactic acid enzymatic dehydrogenation was adopted to detect ALT,and then ELISA was used to reexamine the samples whose ALT40 for HAV and HEV.[Results] From 2006-2011,a total of 136 913 employees working in food and public places received health examination,with total abnormal rate of 3.1%.The abnormal rate of ALT increased from 1.86% in 2006 to 3.91% in 2009 with annual upward tendency,and downward tendency in 2010 and 2011.The detection rate of hepatitis A,hepatitis E among people with ALT40 U/L was between 0.1%-0.5%.The further analysis of employees who received physical examination in 2010 and 2011 showed the positive rate of the ALT（≤20 years） was getting lower from the low-age group to the high-age group,from 4.13% to 2.98%.Unqualified ones concentrated in 21-40 years age group which occupied 67.1% of total abnormal number of cases.ALT abnormal rate of male was much higher than that of female,with significant difference（χ2=767.262,P0.01）.[Conclusion]The ALT abnormal rate is significantly different between employees with genders and different age groups.There is a low proportion caused by HAV and HEV while the large proportion of unqualified in ALT is caused by some non-specific factors.