苏州市2015—2016年疑似新发急性乙型病毒性肝炎监测结果分析

Monitoring result analysis on suspected new cases of acute hepatitis B in Suzhou City from 2015 to 2016

【目的】了解苏州市2015—2016年疑似新发急性乙型病毒性肝炎(乙肝)病例的流行病学情况。【方法】对2015—2016年苏州市医疗机构报告的疑似新发急性乙肝病例进行流行病学调查,调查内容包括社会人口学情况、既往乙肝免疫史和肝病史以及半年内危险因素暴露史等。实验室检测ALT及抗-HBc IgM 1∶1000指标。【结果】2015—2016年对325例疑似新发急性乙肝病例进行了流行病学调查和血标本检测。其中男性256例,女性69例,性别比为3.71∶1。年龄最小的3岁,最大的82岁,平均(40.00±14.15)岁。文化程度以初中者居多,职业以家务及待业者发病居多,其次为农民。抗-HBc IgM 1∶1000阳性256例,阳性率为78.77%。抗-HBc IgM 1∶1000阳性组中,居住在城镇、有乙肝症状和体征者所占比例高于阴性组,差异均有统计学意义(P<0.05)。抗-HBc IgM 1∶1000阳性组ALT水平高于阴性组(P<0.01)。【结论】苏州市新发急性乙肝患者男性发病人数多于女性,抗-HBc IgM 1∶1000阳性者更容易出现乙肝症状和体征及高水平ALT。医务人员应积极利用流行病学史和实验室检测结果进行乙肝分类诊断,以提高报告准确率。

[Objective] To investigate the epidemiological characteristics of suspected new cases of acute hepatitis B in Suzhou City from 2015 to 2016.[Methods] From 2015 to 2016,the suspected new cases of acute hepatitis B reported by the direct network reporting system in the medical institutions in Suzhou were selected as the study subjects.All of them were administered interview using a standard questionnaire and their blood samples were collected.Data was obtained on demographic characteristics,immunization history of hepatitis B,history of liver diseases,risk factors within half a year and so on.Alanine transaminase (ALT) and anti-HBc IgM were tested for all participants.[Results] A total of 325 patients with acute or unclassified hepatitis B were include in the final analysis,of whom 256 were male and 69 female,the sex ratio of male and female being 3.71∶1. The average age of patients was 40.00±14.15 (Min 3 and Max 82 years old).Most people′s education level was junior high school.Many patients were unemployed persons and farmers.The positive rate of anti -HBc IgM 1[KG-*2]∶1000 was 78.77%.Compared to those with anti-HBc IgM 1∶1000 (-),people with anti-HBc-IgM 1∶1000 (+) had higher proportion of living in towns ( P <0.05).The proportion of patients having symptoms of hepatitis B was significantly higher for the people with anti-HBc IgM 1∶1000 (+) than that for the people with anti-HBc IgM 1∶1000 (-)( P <0.05).Patients with anti-HBc IgM 1∶1000 (+) had higher ALT than those with anti-HBc IgM 1∶1000 (-)( P <0.01).[Conclusion] As far as the acute hepatitis B patients are concerned,the proportion of males is higher than that of females in Suzhou City.Patients with anti-HBc IgM 1∶1000 (+) always had symptoms of hepatitis B and higher ALT.Medical personnel should use epidemiological and laboratory tests for hepatitis B classification diagnosis so as to improve reporting accuracy.