2010—2013年淮安市病毒性肝炎血清学诊断符合率调查

Investigation on serological diagnosis coincidence rate of viral hepatitis in Huaian City from 2010-2013

目的了解淮安市2010--2013年报告的病毒性肝炎是否与血清学诊断相符合，掌握诊断报告质量。方法按县区随机在该辖区内的一级、二级及以上医疗机构采集确诊病毒性肝炎病例的血清，在实验室检测核对后比较诊断的符合率。结果病毒性肝炎总的诊断符合率为71．92％，其中乙型肝炎（乙肝）的符合率最高，为91．83％；甲型肝炎（甲肝）的符合率最低，为13．19％；甲肝的诊断符合率在二级及以上的医疗机构和一级医疗机构中存在差别（Fisher确切概率法，P〈0．01）；肝炎合并感染病例的完整报告率为20．37％；以抗-Hbc IgM为参考指标，乙肝急慢性的判断与临床医生报告的型别差异有统计学意义（χ^2=16．62，P〈0．05）。结论淮安市病毒性肝炎的血清学诊断符合率较低，应加强医疗机构传染病诊断标准、报告方面的培训，强化临床医生的责任心，确保疫情信息的准确。

[Objective] To understand whether the types of viral hepatitis were consistent with serological diagnosis Huaian City from 2010-2013, master the quality of diagnosis reporting. [Methods] The serum samples were selected randomly from the confirmed viral hepatitis cases in grade-l, and grade-2 and above hospitals of Huaian City, and the diagnosis coincidence rate was analyzed after laboratory testing. [Results] The total diagnosis coincidence rate of viral hepatitis was 71.92%, and the coincidence rate of hepatitis B was the highest （91.83%）, while that of hepatitis A was the lowest （13.19%）. There was significant difference in the diagnosis coincidence rate of hepatitis A between grade-1 hospitals and grade-2 and above hospitals （Fisher＇ exact test, P〈0.01）. The complete reporting rate of hepatitis co-infection cases was 20.37%. Based on Anti-HBc IgM, there was significant difference in judgment of chronic and acute hepatitis B between laboratory result and clinical classification （χ^2=16.62, P 〈0.05）. [Conclusion] The serological diagnosis coincidence rate of viral hepatitis is low in Huaian City. It is necessary to strengthen training about diagnostic and reporting criteria of infectious diseases, reinforce the clinicians＇ responsibility and ensure the accuracy of epidemic information.