云南省1～29岁人群HBV血清标志物检出模式分析

Analysis on the detection modes of HBV serological markers in population aged 1-29 years old in Yunnan

目的了解云南省1-29岁人群HBV感染状况及血清标志物检测组合模式。方法按照多阶段随机抽样方法，参照2006年全国人群乙型肝炎血清流行病学调查结果，计算抽样人数，在云南省6个疾病监测点抽取1～29岁人群进行问卷调查及血样采集，采用酶联免疫吸附试验检测HBV血清标志物5项，即HB-sAg、抗-HBs、抗-HBc、HBeAg和抗-HBe。结果 本研究共抽取869人进行调查，检出HBV感染57人，感染率为6．56％；共检出8种常见的组合模式，其中以抗-HBs单一阳性最多（496人，57．08％），其次为全阴性模式（316人，36-36％）。1-4岁和5～14岁儿童以单纯抗-HBs阳性为主，分别占73．88％（263／356）和56．54％（147／260）；15～29岁人群以全阴性检测结果多见，占49．80％（126／253）。有免疫史人群中，以抗-HBs单一阳性为主。无乙型肝炎免疫史及免疫史不详人群所检出的HBV血清标志物组合模式构成比比较接近，以全阴模式为主，自然感染所致的组合模式多见。结论云南省HBV血清标志物检出模式由自然感染为主向人工免疫为主的模式转变，但仍存在较大的免疫空白，针对青少年的免疫接种工作仍有待加强。

Objective To investigate the HBV epidemic situation in population aged 1-29 years old in Yunnan, and to analyze the HBV serological marker combination modes. Methods Population aged 1-29 years old were sampled from 6 counties of National Disease Surveillance in Yunnan according to multi-stage random sampling method and the national hepatitis B epidemic results in 2006. Demographic information and hepatitis B vaccination history were collected by questionnaire, and serum samples were taken for testing HBsAg, anti-HBs, anti-HBc, HBeAg and anti-HBe by ELISA method, Results A total of 869 people were enrolled, in which 57 were HBV positive （6.56%）. There were 8 kinds of usual combination modes of HBV markers in the test, and the main was single anti-HBs positive mode （496/869, 57.08% ）, following by all markers negative mode （316/869, 36.36% ）. Among children of 1-4 and 5-14 years old, single anti-HBs positive mode was mainly found, with the proportion of 73.88% （263/356） and 56.54% （147/260）. All markers negative mode was mainly found in 15-29 years old population accounted for 49.80%（126/253）Among immunized population, single anti-HBs positive was the major mode. While among unimmunized and unknown-immunized population, all markers negative mode was accounted for a high proportion, marker combination modes by natural infection were more commonly found. Conclusions Although the main combination profiles of HBV markers change from natural infection to immunity, it still has a large unimmunized population. Thus, it is important to strengthen the immunisation programmes in teenagers.