张家口农村地区乙型肝炎防治现状及对策

Status quo and countermeasures of prevention and treatment of hepatitis B in rural area of Zhangjiakou

目的了解农村地区的乙型肝炎防治现状,分析防治策略中的不足,探索相应的应对措施并提供科学依据。方法在张家口农村地区抽取6个自然农村的居民为研究对象,检测静脉血的乙型肝炎表面抗原(HBsAg)和乙型肝炎表面抗体(抗-HBs),按照人群居住地距离城镇的远近程度分为两组,比较不同年龄段居民中HBsAg和抗-HBs分布的差异,以分析年龄、公共卫生条件对乙型肝炎病毒(HBV)防治效果的影响。结果 HBsAg阳性率平均为5.92%,抗-HBs阳性率平均为33.73%,随着年龄的增长,HBsAg阳性率呈升高趋势,抗-HBs阳性率呈下降趋势;距城镇近的15岁以下(不含15岁)人群抗-HBs阳性率要高于距城镇远的人群。结论需要对农村地区加大财政、人力等方面的投入和支持力度,改善农村地区以计划免疫为主的公共卫生条件,扩大乙型肝炎疫苗接种人群的范围,加强HBV危害及防治知识的宣传,提高新生儿乙型肝炎疫苗接种率和乙型肝炎疫苗24h及时接种率,对HBsAg阳性的孕妇做好免疫阻断,预防在婴幼儿喂养过程中的HBV传播。

Objective To understand the status quo of the prevention and treatment of hepatitis B in rural area ,to analyze the shortages in prevention and treatment strategy ,to explore the corresponding prevention countermeasures and to provide the scientif‐ic basis .Methods The inhabitants were randomly sampled from 6 natural villages in the rural area of Zhangjiakou as the research subjects .The venous blood HBsAg and HBsAb were detected .The respondents were divided into 2 groups according to the distance of residence place from cities and towns .The distribution differences of HBsAg and HBsAb were compared among different age groups for analyzing the influence of age and public health conditions on the HBV control effects .Results The HBsAg positive rate averaged 5 .92% and the HbsAb positive rate averaged 33 .73% ,with the age increase ,the HBsAg positive rate showed the increas‐ing trend and the anti‐HBsAb showed the decreasing trend ;the anti‐HBsAb positive rate in the inhabitants aged under 15 years near town was higher than those far from town .Conclusion It is needed to increase the input and support intensity to the rural areas in the aspects of finance and manpower ,improve the public health conditions of the rural area with the planned immunity as the main thing ,enlarge the hepatitis B vaccine inoculation range ,strengthen the publicity of HBV harm ,prevention and treatment knowledge , increase the neonatal hepatitis B vaccine inoculation rate and the 24 h timely inoculation rate of hepatitis B vaccine ,accomplish the immune blocking in pregnant women with HBsAg positive ,and preventing the HBV communication during feeding process in in‐fants .