昆山市孕产妇乙型肝炎病毒感染状况的流行病学调查

The epidemiological investigation and analysis of the hepatitis B status of pregnant women in kunshan in 2017

目的调查昆山市2017年孕产妇乙型病毒性肝炎(乙肝)的现况,为乙肝的预防和控制提供科学依据。方法选取2017年在昆山市进行初次检查,并有完整产检记录及分娩信息的22595例孕产妇作为研究对象,初次产检时抽取空腹静脉血5011,分离血清,进行乙肝“两对半”[乙肝表面抗原(HBsAg),乙肝表面抗体(HBsAb),乙肝e抗原(HBeAb),乙肝e抗体(HBeAb),乙肝核心抗体(HBcAb)]和肝功能的检测。结果昆山市2017年乙肝“两对半”全部阴性的孕产妇12452例,占55.11%;HBsAb阳性的孕产妇7511例,占33.24%;HBsAg阳性的孕产妇873例,占3.86%。外省户籍HBsAg阳性的孕产妇占比高于其他两组,昆山市户籍HBsAg阳性孕产妇占比最低,差异有统计学意义(P<0.05);随着年龄的升高,HBsAg阳性的孕产妇占比逐渐升高,差异有统计学意义(P<0.05)。HBsAg阳性孕产妇的谷丙转氨酶、谷草转氨酶的异常率均高于HBsAg阴性的孕产妇,差异有统计学意义(P<0.05)。结论昆山地区孕产妇HBV携带率仍较高,乙肝疫苗接种率低,应该联合卫生行政部门,倡导乙肝疫苗接种的同时监测HBsAb水平,必要时进行免疫强化,保护易感人群,降低乙肝的母婴传播。

Objective To investigate and analyze the hepatitis B status of pregnant women in kunshan in 2017,so as to provide scientific evidences for the prevention and control of hepatitis B.Methods 22 595 pregnant women were selected in our study,second liver two half-and-half and liver function were detected.Results There were 12 452 pregnant women with all negative results of second liver two half-and-half,accounting for 55.11%;7511 pregnant women with positive HBsAb,accounting for 33.24%;873 pregnant women with positive HBsAg,accounting for 3.86%.The proportion of positive HBsAg in migrant pregnant women was higher than that in the locals(P<0.05).With the increase of age,the proportion of positive HBsAg increased(P<0.05).The abnormality rate of ALT and AST in pregnant women with positive HBsAg were higher than that in pregnant women with negative HBsAg(P<0.05).Conclusion The pro|>ortion of positive HBsAg in pregnant women was higher,and the proportion of positive HBsAb was lower.The public health administrative department should be combined to advocacy the hepatitis B vaccination,monitor the level of HBsAb,and strengthen the hepatitis B vaccination When it is necessary.In order to protect the vulnerable groups,reduce mother-to-child transmission of hepatitis B.