医务人员乙型肝炎病毒感染相关危险因素分析

Risk factors for hepatitis B virus infection in medical staff

目的了解医务人员乙型肝炎病毒(HBV)感染现状与相关危险因素,为医务人员HBV防治提供参考依据。方法将882名医务人员按与血液接触密切程度分为血液少接触组、血液一般性接触组、血液密切接触组;用酶联免疫吸附试验(ELISA)检测HBV5项血清学标志物:HBsAg、抗-HBs、HBeAg、抗-HBe和抗-HBc;自行设计调查问卷调查人口学特征、乙型肝炎疫苗接种及参加HBV防护知识培训状况。结果医务人员HBV感染率为23.92%,免疫率为50.11%,易感率为29.49%;血液少接触组、一般性接触组、密切接触组HBV感染率分别为24.35%、18.82%、33.97%,HBV免疫率分别43.26%、66.76%、30.77%,HBV易感率分别为36.27%、18.82%、43.59%,3组比较差异有统计学意义(P<0.05);职工年龄、性别、学历、乙型肝炎疫苗接种和参加HBV防治相关知识培训与HBV感染密切相关。结论医务人员HBV感染与血液密切接触程度呈正相关,医务人员HBV感染风险男性高于女性,低学历高于高学历,应重视HBV防治知识培训与预防接种。

OBJECTIVE To understand the prevalence of hepatitis B virus（HBV）infection in medical staff and analyze the related risk factors so as to provide guidance for prevention and treatment of HBV infection in the medical staff.METHODS Totally 882medical staff were divided into,according to the degree of their contacting to blood, the less contact group,the general contact group,and the close contact group,then the enzyme-linked immunosorbent assay was performed to detect the five serological markers of HBV,including HBsAg,anti-HBs, HBeAg,anti-HBe,and anti-HBc;the demographic characteristics,status of vaccination of hepatitis B vaccine, and attendance to training of prevention knowledge of HBV were investigated by using self-designed questionnaire. RESULTS The incidence of HBV infection was 23.92%in the medical staff,the immunization rate was 50.11%, and the susceptible rate was 29.49%.The incidence rate of HBV infection was 24.35%in the less contact group, 18.82%in the general contact group,33.97%in the close contact group;the rate of immunization to HBV was 43.26%in the less contact group,66.76%in the general contact group,30.77%in the close contact group;the rate of the susceptible to HBV infection was 36.27%in the less contact group,18.82%in the general contact group,43.59%in the close contact group,with significant difference between the three groups（P〈0.05%）.The related risk factors for the HBV infection in the medical staff included the age,gender,education level,vaccination of hepatitis B vaccine,and attendance to the knowledge training of prevention of HBV infection. CONCLUSIONThe HBV infection in the medical staff is positively correlated with the degree of contacting with blood;the male medical staff are at higher risk of HBV infection than the female medical staff,and the medical staff with low education level are at higher risk than the medical staff with high education level.It is necessary to attach great importance to the knowledge training of prevention of HBV infection and the vaccination.