四川省1990-2000年乙型肝炎发病的队列分析

Cohort Study of Hepatitis B Incidence from 1990 to 2000 Years in Sichuan Province

目的 分析四川省乙型肝炎流行的规律及其影响因素 ,指导乙型肝炎疫苗接种等防治工作 方法 采用流行病学队列分析方法对四川省 1990 -2 0 0 0年报告的乙型肝炎发病率进行分析。结果 1990 -2 0 0 0年的 11年间 ,0岁组儿童乙型肝炎的报告发病率呈逐年上升的趋势 ,各出生队列儿童的乙型肝炎报告发病率都随其年龄增长而增加 ,同期 ,2 0～ 49岁妇女的平均乙型肝炎的报告发病率也呈逐年上升的趋势。各出生队列儿童的乙型肝炎的报告发病率均随其年龄增长而增加 ,可能与HBV经母婴传播引起儿童发病是逐渐凸现 ,一个病例被报病多次 ,儿童出生后以HBV的暴露如预防性和治疗性注射等医源性感染逐年增加有关。由于经济的原因 ,接种工作无法重点保证新生儿这个目标人群 ,接种率一直处于较低水平 ,没有充分发挥接种乙型肝炎疫苗阴断HBV母婴传播的应有作用。结论 大力推广新生儿乙型肝炎疫苗接种 ,提高 12月龄内儿童乙型肝炎疫苗全程合格接种率 ,降低不安全注射等医源性感染的危险 ,是遏制四川省儿童乙型肝炎发病上升趋势和降低全人群乙型肝炎发病率的主要措施。在社会经济不发达地区推广新生儿乙型肝炎疫苗接种需要一定的政府投入。

Objective Analysis the epidemic rule of hepatitis and its affecters,guide immunization of hepatitis B vaccine and other prevention work.Methods Analysis hepatitis B incidence from 1990 to 2000 years in Sichuan privince by cohort study.Results From 1990 to 2000 years,hepatitis B incidences in 0-year old were going up by year,hepatitis B incidence in every cohort was going up as the age growing,in the same time,Hepatitis B incidences of women in 20～49 years old were going up by year.The reasons of hepatitis B incidence in every cohort going up as the age growing maybe these,hepatitis B in children via mother-infant transmission is being taken bad gradually,one case of hepatitis B was reported time after time,expose to HBV,such as unsafe injection,is growing by age.Because of underdevelopment economy in Sichuan,immunization of hepatitis B vaccine in infant,the target population,could not meet so that the vaccine coverage rate in infant was very low (3 doses,26 9%),the effect of hepatitis B vaccine blocking mother-infant transmission of HBV could not be brought into play in past 11years. Conclusions To keep within limits of the growing trend on hepatitis B incidences in children by promoting immunization of hepatitis B vaccine in newborn baby,heightening the vaccine coverage rate in infant and depressing the risk of iatrogenic infection such as umsafe injection.Promoting immunization of hepatitis B vaccine in newborn baby in underdevelopment ardea needs financial support from government.