2017年新疆南疆地区7月龄~4岁儿童乙型病毒性肝炎血清流行病学调查结果分析

Seroepidemiological Survey of Hepatitis B Among Children Aged 7 Months to 4 Years in Southern District of Xinjiang in 2017

目的了解新疆南疆地区儿童乙肝病毒(HBV)感染情况和免疫状况,评价免疫接种效果,为儿童乙肝防控提供依据。方法 2017年收集南疆地区县级及以上综合医院非肝炎原因就诊的7月龄~4岁1 200例儿童血清。用酶联免疫吸附试验(ELISA)方法检测乙肝病毒感染血清标志物,率之间的比较采用χ^(2)检验,以P<0.05为差异有统计学意义。结果新疆南疆地区7月龄~4岁儿童乙肝病毒表面抗原(HBsAg)阳性率为0.58%(标化阳性率0.50%),乙肝病毒表面抗体(抗-HBs)阳性率为65.42%(标化阳性率65.06%),乙肝病毒核心抗体(抗-HBc)阳性率为0.92%(标化阳性率0.78%),HBV感染率为1.33%(标化阳性率1.14%)。各地区的HBsAg阳性率差异有统计学意义(χ^(2)=17.249,P<0.05),喀什地区最高(2.28%)。各地区的抗-HBs阳性率差异有统计学意义(χ^(2)=52.143,P<0.05),巴州最高(76.49%),喀什地区最低(52.09%)。抗-HBs阳性率有随免疫次数增大而逐渐增高的趋势,差异有统计学意义(χ^(2)=312.577,P<0.05),≥3剂次免疫史人群的最高(74.69%)。不同免疫次数的抗-HBc阳性率和HBV感染率差异均有统计学意义(P均<0.05),无免疫史人群的最高(均为50.00%)。结论南疆地区儿童HBV感染率较低,实施新生儿乙肝疫苗预防接种已取得显著成效,今后需提高疫苗接种率,特别是提高24小时内新生儿首针及时接种率和全程接种率。

Objective To understand the status of hepatitis B virus(HBV) infection and immunization among children in southern district of Xinjiang,and evaluate the effect of immunization so as to provide the basis for the prevention and control of hepatitis B in children.Methods Serum samples of 1 200 non-hepatitis children aged 7 months to 4 years from general hospitals at county level or above in southern district of Xinjiang were collected.All participants were detected for serum makers of HBV infection by enzyme-linked immunosorbent assay(ELISA).Chisquare tests were used to compare different rates,and significance level was set at the P<0.05.Results The positive rates of HBsAg,Anti-HBs,Anti-HBc and infection rate of HBV among 1 200 children were 0.58%,65.42%,0.92%,and 1.33%,respectively.The standardized rates of HBsAg,Anti-HBs,Anti-HBc and infection rate of HBV were 0.50%,65.06%,0.78%,and 1.14%,respectively.The differences of positive rates of HBsAg among different areas were statistical significant(χ^(2)=17.249,P<0.05);noticeably,the positive rate of HBsAg in Kashi area was the highest(2.28%).There were significant statistical differences of positive rates of anti-HBs among different areas(χ^(2)=52.143,P <0.05);notably,the positive rate of anti-HBs in Bazhou area was the highest(76.49%) and in Kashi area was the lowest(52.09%).The positive rate of anti-HBs increased with the increase of the times of immunization(χ^(2)=312.577,P<0.05).The positive rate of antiHBs in population with more than 3 doses of immunization history was the highes t(74.69%).Significant differences of positive rates of anti-HBc and infection rates of HBV among different immunization times were observed(P<0.05).The positive rate of anti-HBc and infection rate of HBV in children with no immunization history was the highest(50.00%).Conclusion The infection rate of HBV among children is low in southern district of Xinjiang.Great achievement had been made in hepatitis B prevention and control through the implementation of newborn Hepatitis B vaccine vaccination.Future work is needed to improve the vaccination rate,especially to improve the first injection rate of newborns within 24 hours and full coverage rate.