住院精神病病人2250例肝炎病毒感染及其影响因素的logistic回归分析

Logistic regression analysis of hepatitis virus infections in 2250 cases of psychiatric inpatients and the influencing factors

目的探讨住院精神病病人甲型肝炎病毒(HAV)、乙型肝炎病毒(HBV)、丙型肝炎病毒(HCV)感染发生率,并logistic回归分析感染影响因素。方法选取新乡医学院第二附属医院2014年1月至2019年8月2250例住院精神病病人作为研究对象。取清晨空腹静脉血检测抗HAV、HBV、HCV表面抗原,统计HAV、HBV、HCV感染发生率、感染病人相关指标阳性表达情况,并收集其临床资料,对比不同临床特征病人HAV、HBV、HCV感染发生率,logistic回归分析病毒性肝炎感染影响因素。结果2250例住院精神病病人中发生病毒性感染457例,HAV、HBV、HCV感染发生率分别为1.11%、17.87%、2.49%;单一抗乙型肝炎表面抗原(HBsAg)阳性、单一抗HCV阳性占比高于单一抗甲型肝炎病毒-免疫球蛋白M(HAV-IgM)阳性、抗HAV-IgM+HBsAg阳性、抗HAV-IgM+抗HCV阳性、HBsAg+抗HCV阳性;不同年龄、性别、流浪史、生活自理能力病人HAV、HBV、HCV感染情况相比,差异有统计学意义(P<0.05);年龄>20~40岁、女性、流浪史、无生活自理能力是住院精神病病人发生病毒性感染的独立危险因素(P<0.05)。结论住院精神病病人存在HBV感染高风险,且部分重叠感染,感染风险与年龄、性别、流浪史、生活自理能力有关,需结合实际情况强化此类病人病毒性肝炎防控措施。

Objective To investigate the incidences of hepatitis A virus(HAV),hepatitis B virus(HBV),and hepatitis C virus(HCV)infections in hospitalized psychiatric patients,and to analyze the factors influencing the infections using logistic regression.Methods A total of 2250 inpatients with psychosis hospitalized in Second Affiliated Hospital of Xinxiang Medical College from January 2014 to August 2019 were selected as the study subjects.Early morning fasting venous blood was taken to detect anti-HAV,HBV and HCV surface antigen,and the incidence of HAV,HBV and HCV infection,positive expression of related indexes in infected patients were counted,and their clinical data were collected to compare the incidences of HAV,HBV and HCV infection in patients with different clinical characteristics,and logistic regression was used to analyze the factors influencing viral hepatitis.Results There were 457 viral infections among 2250 psychiatric inpatients.The incidences of HAV,HBV,and HCV infections were 1.11%,17.87%,and 2.49%,respectively.The proportions of single anti-hepatitis B surface antigen(HBsAg)positivity and single anti-HCV surface antigen positivity were higher than those of single anti-hepatitis A virus-immunoglobulin M(HAV-IgM)positivity,anti-HAV IgM+HBsAg positivity,anti-HAV-IgM+anti-HCV positivity,and HBsAg+anti-HCV positivity.The differences were statistically significant(P<0.05)in HAV,HBV,and HCV infections in patients with different ages,genders,history of vagrancy,and self-care abilities.Age>20-40 years,female,history of vagrancy,and lack of self-care ability were independent risk factors for viral infections among hospitalized psychiatric patients(P<0.05).Conclusion Psychiatric inpatients are at high risk of HBV infection with some overlapping infections,and the risk of infection is related to age,gender,history of vagrancy,and self-care ability,and preventive and control measures for viral hepatitis among such patients need to be strengthened on the basis of the actual situation.