婚检与孕检医学检查中艾滋病、梅毒、乙型肝炎对比分析

Detection rates of AIDS,syphilis,and hepatitis B in premarital medical examination and prenatal examination: a comparative analysis

目的了解北京市朝阳区婚检与孕检医学检查中艾滋病、梅毒、乙型肝炎感染情况。方法回顾性分析2008-2015年朝阳区《婚前医学检查年报表》和《疾病分类编码表》及检验科信息管理系统,对21302名婚检人群的男女双方艾滋病、梅毒、乙型肝炎结果以及8年来婚检与孕检结果进行统计学对比分析。结果在北京市大力推行免费婚检的背景下,朝阳区整体婚检率略有降低,由2008年的7.31%降到2015年的5.37%。在婚检传染性疾病中,HBsAg阳性居首位,检出率为19.90‰,男性高于女性,且男女受检者HBsAg阳性率存在统计学差异（χ^2=19.131,P=0.000）;在梅毒和艾滋病检测中,男女受检者阳性率均无统计学差异（χ梅^2=1.298,P梅=0.225;χ艾^2=2.989,P艾=0.126）。在孕期检查中,乙肝自2012年以来呈现增长趋势,HBsAg阳性检出率明显大于婚检,且两者对比差异具有统计学意义（χ^2=38.975,P=0.000）;在梅毒和艾滋病检测中,孕检与婚检检出率比较无统计学差异（χ梅^2=0.635,P梅=0.288;χ艾^2=1.321,P艾=0.294）。结论在母婴艾滋病、梅毒、乙型肝炎的防治中,孕检起到了重要的作用,但是孕检不能代替婚检;婚检作为预防两性和新生儿感染的第一道防线,不应该被撤除,应将艾滋病、梅毒、乙型肝炎作为婚姻登记人群的必检项目。

Objective To understand the detection rates of AIDS,syphilis,and hepatitis B in premarital medical examination and prenatal examination. Methods Annual report of premarital medical examination,encoding table of disease classification,and laboratory information system were analyzed retrospectively,the detection results of AIDS,syphilis,and hepatitis B among 21 302 persons and premarital medical examination and prenatal examination results in the last eight years were compared and analyzed statistically. Results Under the background of vigorously promotion of free premarital examination in Beijing,the overall premarital rate in Chaoyang District decreased slightly. The premarital examination rate dropped from 7. 31% in 2008 to 5. 37% in 2015. Among the infectious diseases during premarital examination,the detection rate of positive HBs Ag was the highest（ 19. 9 per thousand）. The detection rate among men was statistically significantly higher than that among women（ χ^2= 19. 131,P = 0. 000）; there was no statistically significant difference in positive rates of syphilis and AIDS between men and women（ χ^2syphilis= 1. 298,Psyphilis= 0. 225; χ^AIDS= 2. 989,PAIDS= 0. 126）. The detection rate of hepatitis B showed an increasing trend during prenatal examination since 2012,the positive detection rate of Hbs Ag was statistically significantly higher than that during premarital medical examination（ χ^2= 38. 975,P = 0. 000）; there was no statistically significant difference in the detection rate of syphilis and AIDS between premarital medical examination and prenatal examination（ χ^2syphilis= 0. 635,Psyphilis= 0. 288; χ^2AIDS= 1. 321,PAIDS= 0. 294）. Conclusion Prenatal examination plays an important role in prevention and treatment of maternal-neonatal transmission of AIDS,syphilis,and hepatitis B,but it can not be replaced by premarital medical examination; as the first line of defense to prevent sexual and neonatal infections,premarital medical examination should not be removed,it is suggested that every one participating in marriage registration should check AIDS,syphilis,and hepatitis B.