中国2014年HBsAg阳性母亲所生1～14岁儿童乙型肝炎血清流行病学特征分析

Sero-epidemiological analysis on hepatitis B among children aged 1-14 years old born to HBsAg positive mother in China, 2014

目的 分析HBsAg阳性母亲所生1～14岁儿童乙肝血清流行病学特征。方法 以2014年全国乙型肝炎（乙肝）血清流行病学调查中母亲HBsAg阳性的1～14岁儿童作为研究对象，采用SPSS 18.0软件分析不同性别、年龄、民族、出生地点、城乡、地区的儿童HBsAg、抗-HBs、抗-HBc阳性率以及HBsAg、抗-HBs影响因素等。结果 共分析HBsAg阳性母亲所生的1～14岁儿童645人，HBsAg、抗-HBs、抗-HBc阳性率分别为3.41%（22/645）、71.94%（464/645）、7.60%（49/645）。其中，1～、3～、5～、10～14岁组HBsAg阳性率分别为1.27%（3/236）、3.23%（6/186）、5.71%（8/140）、6.02%（5/83），抗-HBs阳性率分别为85.17%（201/236）、69.35%（129/186）、56.43%（79/140）、66.27%（55/83），抗-HBc阳性率分别为4.66%（11/236）、5.38%（10/186）、11.43%（16/140）、14.46%（12/83）。多因素logistic分析结果显示，出生地点、首针乙型肝炎疫苗（HepB）接种时间是影响HBsAg阳性母亲所生儿童HBsAg阳性率的主要因素，在医院外出生儿童HBsAg阳性率高于在医院内出生者（OR=7.47，95%CI：1.50～37.25），首针HepB出生后〉 24 h接种儿童HBsAg阳性率高于出生后≤24 h接种者（OR=6.21，95%CI：2.15～17.99）。结论 我国乙肝母婴阻断取得一定成效。住院分娩和首针HepB及时接种仍是新生儿乙型肝炎母婴阻断工作的重点。

Objective To analyze the sero-epidemiological features of hepatitis B among children aged 1-14 years old who were born to HBsAg positive mothers. Methods Based on the results from the hepatitis B national sero-survey in 2014, children aged 1-14 years old born to HBsAg positive mother were involved in this study. Positive rates on HBsAg, anti-HBs, anti-HBc by gender,age, nationality, birth place, residency （urban/rural）, region （eastern/central/western） and related factors of HBsAg and anti-HBs for children under research, were analyzed by SPSS 18.0 statistical software. Results A total of 645 children aged 1-14 years old that born to HBsAg positive mothers were analyzed in the study. Positive rates on HBsAg, anti-HBs, anti-HBc among these children were 3.41% （22/645）, 71.94% （464/645） and 7.60% （49/645）, respectively. HBsAg positive rates for children aged 1-2 years, 3-4 years, 5-9 years, 10-14 years appeared 1.27% （3/236）, 3.23% （6/186）, 5.71% （8/140） and 6.02% （5/83）, respectively. The anti-HBs positive rates were 85.17% （201/236）, 69.35% （129/186）, 56.43% （79/140）, 66.27% （55/83） while the anti-HBc positive rates were 4.66% （11/236）, 5.38% （10/186）, 11.43% （16/140） and 14.46% （12/83）, respectively. Results from the multifactor logistic analysis showed that birth place, time of the first dose of HepB inoculation were major influencing factors on the positive rates among children with HBsAg. HBsAg positive rate for the children born outside the hospital was higher than those born in the hospital （OR=7.47, 95%CI：1.50-37.25）. HBsAg positive rate for children with the first dose of HepB inoculation〉 24 h after birth, was higher than that inoculation within 24 h after birth （OR=6.21, 95%CI： 2.15-17.99）. Conclusions Some achievements in preventing mother-to-child transmission of hepatitis B had been seen in China. Hospital delivery for pregnant women and timely HepB vaccination with birth-dose for the neonates, remained the key strategy on prevention of HBV vertical transmission.