北京市急性乙型肝炎病毒经血和性接触传播的危险因素分析

Risk factors of acute hepatitis B virus through blood and sexual contact transmission in Beijing

目的了解北京市急性HBV经血和性接触传播的危险因素。方法选择2013年1月至2014年12月国家法定传染病信息报告系统中的急性乙型肝炎患者301例，采用1：2配对方法选取与患者性别、年龄和居住街（乡）相同的健康者602名作为健康对照。对所有病例和对照进行感染危险因素问卷调查。组间比较采用X2检验，Logistic回归分析急性HBV经血和性接触传播的危险因素。结果单因素分析发现，目前北京市急性HBV经血和性接触传播的主要危险因素为半年以上医疗机构注射药物史（X2=5．45，p=0．03）、手术史（X2=6．94，P=0．01）、龈上洁治术（X2=4．21，P=0．05）、捐献成分血（X2=4．43，P=0．04）、家庭成员密切接触史（X2=8．19，P=0．01）、修足（X2=4．41，P=0．04）、刮痧（X2=6．94，P=0．01）、拔罐（X2=8．94，P=0．00）。多因素条件Logistic分析将单因素分析有意义的危险因素带入方程中，结果发现半年以上医疗机构注射药物史（OR=3．44，95％CI：1．31～9．01）、手术史（OR=4．03，95％CI：1．44～11．30）、家庭成员密切接触史（OR=3．17，95％CI：1．32～7．65）和拔罐（OR=1．87，95％CI：1．03～3．40）是目前北京市急性HBV经血和性接触传播的危险因素。多因素条件Logistic分析将所有危险因素变量带入方程中，结果发现手术史（OR=1．45，95％CI：1．45～26．84）和文眉、文眼线、文身等创伤性医学美容史（OR=6．83，95％CI：1．06～44．16）是目前北京市急性HBV经血和性接触传播的危险因素。结论北京市急性HBV经血和性接触传播危险因素为半年以上医疗机构注射药物史，手术史、家庭成员密切接触史、拔罐和创伤性医学美容史。

Objective To investigate the risk factors of acute hepatitis B virus through blood and sexual contact transmission in Beijing. Methods A population-based 1：2 matched case-control study was used in our survey. Three hundred and one acute hepatitis B cases living in Beijing more than one year reported in National Notifiable Disease Reporting System from January 2013 to December 2014 were recruited as cases. Six hundred and two sex-, age- and resident-matched individuals were selected as controls, All cases and controls were interviewed by questionnaires. Categorical variables were compared using chi-square test between groups. Risk factors for acute hepatitis B virus through blood and sexual contact transmission were calculated by Logistic regression model. Results Univariate factor analysis showed that history of drug injection in hospital more than half a year （X2 = 5.45, P= 0.03）, surgery （X2 = 6.94, P= 0.01 ）, supragingival scaling （X2= 4.21, P = 0.05）, component blood donation （X2= P=0. 04）, close household contact （X2 =8.19, P=0. 01） ,pedicure （X2=4.41, P=0. 04）, scraping 4. 43, （X2 =6.94, P=0.01） and cupping （X2= 8. 94, P= 0.00） were the risk factors for acute hepatitis B virus through blood and sexual contact transmission. Multivariate Logistic analysis enrolled risk factors with significance into equation and showed that history of drug injection in hospital more than half a year （OR= 3.44, 95% CI：1.31-9.01）, surgery （OR=4.03, 95% CI： 1.44-11.30）, close household contact （OR= 3.17, 95% CI： 1.32- 7.65） and cupping （OR = 1.87, 95% CI： 1.03 - 3.40） were the risk factors for acute hepatitis B virus through blood and sexual contact transmission. Multivariate Logistic analysis enrolled all risk factors into equation and showed that history of surgery （OR= 1.45, 95% CI：1.45- 26.84）, traumatic medical cosmetology （OR = 6. 83, 95% CI：1.06- 44. 16） were the risk factors for acute hepatitis B virus through blood and sexual contact transmission. Conclusion History of drug injection in hospital more than half a year, surgery, close household contact, cupping and traumatic medical cosmetology are the risk factors for acute hepatitis B virus through blood and sexual contact transmission in Beijing.