29290例0～7岁儿童乙型肝炎病毒血清学模式分析

Distribution characteristics of hepatitis B virus serological patterns in 292900-7-year-old children

目的了解0—7岁儿童乙型肝炎病毒（HBV）血清学模式及其分布特征。方法收集2013年1月至12月重庆医科大学附属儿童医院0～7岁就诊儿童HBV血清学标志物检测结果及HBV表面抗原（HBsAg）（＋）患儿家族史，对其资料进行回顾性分析。结果共检出17种血清学模式，各模式在不同年龄组检出率不同。HBsAg总检出率为0．32％，各年龄组HBsAg检出率差异无统计学意义。模式10“HBV表面抗体（抗-HBs）（＋）、HBV核心抗体（抗-HBc）（＋）”、模式11“抗-HBs（＋）、HBVe抗原（HBeAg）（＋）、抗-HBc（＋）”、模式12“抗-HBs（＋）、HBVe抗体（抗-HBe）（＋）、抗-HBc（＋）”、模式16“抗-HBc（＋）”及模式17“抗-HBe（＋）、抗-HBc（＋）”在0～28d组、〉28d至1岁组的检出率均明显高于其余各年龄组（P〈0．05）。HBV前S1抗原（Pre Sl-Ag）（＋）见于5种血清学模式，以“HBsAg（＋）、HBeAg（＋）”模式检出率最高（100％），其次为“HBsAg（＋）、HBeAg（＋）、抗-HBc（＋）”模式（80．77％）。PreS1-Ag在HBeAg（＋）组中的检出率为80．72％，明显高于HBeAg（-）组（25．00％），两组检出率比较，差异具有统计学意义（X^2=14．083，P=0．000）。结论重庆医科大学附属儿童医院0～7岁儿童HBsAg阳性率随年龄增长无明显变化，而HBV血清学模式分布与年龄相关。PreS1-Ag与HBeAg具有相关性，二者联合检测能更好地反映HBV复制情况，具有重要临床价值。

Objective To investigate the serological patterns of hepatitis B virus and the distribution characteristics among 0-7-year-old children. Methods The detection results of hepatitis B virus serological markers （HBVM） in 0- 7-year-old children and the family history of ＇HBsAg（＋ ）＇ children from Children＇s Hospital of Chongqing Medical University in 2013 were analyzed retrospectively. Results Seventeen serological patterns of hepatitis B virus were found, and the detection rate of each pattern in different age groups was different. The positive rate of HBsAg was 0.32%, and there were no significant differences in HBsAg positive rate in different age groups. The detection rates of ＇anti-HBs （＋） anti-HBc （ ＋ ）＇ , ＇ anti-HBs （ ＋ ） HBeAg（ ＋ ） anti-HBc （ ＋ ）＇ , ＇ anti-HBs （ ＋ ） anti-HBc （ ＋ ） anti-HBc （ ＋ ）＇ ,‘anti-HBc （＋）＇ and ‘anti-HBe （＋） anti-HBc （＋）＇ in 0 to 28 day age group and 1 month to 1-year age group were significantly higher than other age groups （P 〈 0.05）. PreS1-Ag was detected in five serological patterns, the highest frequency pat- tern was ‘HBsAg（＋） HBeAg（＋） ＇ （100%）, followed by ‘HBsAg（＋） HBeAg（＋） anti-HBc（＋） ＇. The detection rate of PreS1-Ag in the HBeAg （＋） group was 80.77%,which was significantly higher than the HBeAg （-） group （X2 = 14.083, P = 0.000）. Conclusion There is no significant change in positive rate of HBsAg with the increase of age among 0-7- year-old children in Chongqing, but the distribution of serological patterns is associated with age. There is correlation between PreS1-Ag and HBeAg, and the combined test of the two serological markers can better reflect the HBV replication, which has important clinical value.