新疆农牧区中小学生乙型肝炎表面抗体阴性影响因素分析

Analysis on influencing factors of negative HBsAb in primary and middle school students in rural and pastoral areas of Xinjiang

目的了解新疆农牧区中小学生乙型肝炎表面抗体（抗-HBs）阴性率及其影响因素。方法：采用整群抽样法纳入3所农牧区学校所有中小学生作为研究对象，进行结构式问卷调查并采集血清标本，应用电化学发光法检测乙肝表面抗原（HBsAg），ELISA方法检测抗-HBs。结果：在调查的中小学生中，HBsAg携带率为1．9％（33／1712），抗-HBs阴性率为42．4％（712／1679）。与抗-HBs阴性相关的因素为民族、足月产及乙肝疫苗接种情况，其调整OR值分别为：汉族与哈萨克族（哈族）[0．38（95％可信区间：0．28—0．51）]，回族与哈族[0．60（0．45—0．80）]，子女早产与患儿足月产[1．48（1．05—2．09）]，乙肝疫苗首针及时接种但未加强与患儿首针及时且加强[1．34（1．07—1．69）]，首针未及时且未加强与患儿首针及时且加强[1．70（1．29—2．23）]。结论：新疆农牧区中小学生仍存在相当数量的抗-HBs阴性者，应适时对该人群进行乙肝疫苗加强接种。

Objective To understand the negative rate and influencing factors of HBsAb in primary and middle school students in rural and pastoral areas of Xinjiang. Methods： All the students in three primary and middle schools of rural and pastoral areas of Xinjiang wereselected as study objects by cluster sampling method, structured questionnaire investigation was performed and serum samples were collected;electrochemiluminescence was used to detect HBsAg; ELISA was used to detect HBsAh. Results：Among the primary and middle schoolstudents, the carrying rate of HBsAg was 1.9% （33/1 712）, the negative rate of HBsAb was 42. 4% （712/1 679） ; the related factors ofnegative rate of HBsAb were nationality, mature birth and hepatitis B vaccination, the adjusted OR values were 0. 38 （95% confidence interval： 0. 28 -0. 51 ） （Han nationality versus Kazak nationality）, 0. 60 （95% confidence interval： 0. 45 -0. 80） （Hui nationality versus Ka-zak nationality）, 1.48 （95% confidence interval： 1.05 -2. 09） （premature birth versus mature birth）, 1.34 （95% confidence interval：1.07 - 1.69 ） （ timely first dose of hepatitis B vaccine inoculation but not booster inoculation versus timely first dose of hepatitis B vaccine in-oculation versus booster inoculation） 1.70 （95 % confidence interval ： 1.29 - 2. 23 ） （ not timely first dose of hepatitis B vaccine inoculationand not booster inoculation versus timely first dose of hepatitis B vaccine inoculation and booster inoculation）. Conclusion：There are still alarge number of primary and middle school students with negative HBsAb, hepatitis B vaccination should he reinforced for this population.