绵阳市成年人HBV感染现况及相关因素分析

The prevalence and related factors of HBV infection among adults in Mianyang

目的 分析绵阳市≥18岁人群HBV感染现况及其相关因素.方法 于2014年11月至2015年9月,采取多阶段随机抽样方法,抽取绵阳市260950名18岁及以上常住居民（在当地居住时长大于6个月）为研究对象.采用自行设计的问卷调查研究对象一般人口学特征、乙型肝炎家族史、乙型肝炎疫苗接种史、现病史等;采集研究对象空腹静脉血5 ml,离心后采用ELISA对血标本进行HBsAg检测.采用多因素非条件logistic回归模型中逐步前进法分析研究对象HBsAg阳性的影响因素.结果 260950名研究对象的年龄为（47.68±17.36）岁,男性为113184名（43.37％）;HBsAg阳性率为6.10％（15822例）.与18～24岁人群相比,25～34、35～44、45～54、55～64岁人群HBsAg阳性的可能性较大,OR值分别为1.23、1.26、1.23、1.34,而≥65岁人群HBsAg阳性的可能性较小,OR值为0.88;与女性相比,男性HBsAg阳性的可能性较大（OR=1.35）;与江油市居民相比,涪城区居民HBsAg阳性的可能性较大（OR=1.91）;与未婚相比,已婚者HBsAg阳性的可能性较大（OR=1.36）;与非医务人员相比,医务人员HBsAg阳性的可能性较小（OR=0.61）;与无手术史者相比,有手术史者HBsAg阳性的可能性大（OR=1.13）;与无外伤史者相比,有外伤史者HBsAg阳性的可能性较大（OR=1.13）;与无乙型肝炎家族史者相比,有乙型肝炎家族史者HBsAg阳性的可能性较大（OR=4.21）;与无乙型肝炎疫苗接种史者相比,有乙型肝炎疫苗接种史者HBsAg阳性的可能性较小（OR=0.48）;以上P值均〈0.05.结论 绵阳市≥18岁人群HBsAg阳性率较高;需重点关注25～64岁、男性、医务人员、有手术史、有外伤史、有乙型肝炎家族史和有乙型肝炎疫苗接种史人群.

Objective To analyze the prevalence and related factors of HBV infection among people aged 18 years old and above in Mianyang city. Methods A total of 260950 residents, living in Mianyang city more than 6 months, aging 18 years old and above were employed by multi-stage random sampling method from November 2014 to September 2015. Questionnaire survey was conducted on participants using a self-designed questionnaire, including general demographic characteristics, family history of Hepatitis B, history of Hepatitis B vaccination and history of present illness, etc. 5ml blood was collected from all participants, and the blood samples were detected for HBsAg by enzyme-linked immunosorbent assay （ELISA）. The multivariate unconditional logistic regression was performed to identify the related factors of positive HBsAg. Results Among the 260950 subjects, 113184 were males （43.37%）, 147766 were females （56.63%）, and the average age was （47.68 ＆#177; 17.36） years old. The positive rate of HBsAg was 6.10%（15822 cases）. Subjects who were 25-34 years old （OR=1.23）, 35-44 years old （OR=1.26）, 45-54 years old （OR=1.23）, and 55-64 years old （OR=1.34） were more likely to be HBsAg positive,65 years and older （OR=0.88） were less likely to be, compared with subjects aging 18-24 years old;males were more likely to be HBsAg positive compared with females （OR=1.35）;people living in Fucheng district were more likely to be HBsAg positive compared with who living in Jiangyou district（OR=1.91）; married people were more likely to be HBsAg positive compared with unmarried ones （OR=1.36）;medical staff were less likely to be HBsAg positive compared with non-medical staff （OR=0.61）;subjects with a surgery history were more likely to HBsAg positive compared with who without （OR=1.13）;subjects with trauma history were more likely to HBsAg positive compared with who without （OR=1.13）;people with history of Hepatitis B were more likely to HBsAg positive compared with who without （OR=4.21）; people with Hepatitis B vaccination history were less likely to be HBsAg positive compared with who without （OR=0.48）;all the P values above were less than 0.05. Conclusion The positive rate of HBsAg among adults in Mianyang city was very high, and we should pay more attention to people aging between 25 and 64 years old, male, medical staff, with surgery history, trauma history, and a family history of Hepatitis B and Hepatitis B vaccination history.