浦江县食品、公共场所从业人员乙肝感染状况及危险因素研究

发布时间：2018-04-05 23:04

本文选题：从业人员　切入点：乙肝感染　出处：《浙江大学》2011年硕士论文

【摘要】：背景：乙型病毒性肝炎是由乙型肝炎病毒(HBV)引起的一种世界性疾病,在五种病毒性肝炎中,乙肝对人类健康的危害最严重。乙肝的感染流行,已经成为我国的主要公共卫生问题之一,2006年调查显示,我国乙肝感染率较前几年虽有所下降,但人群HBsAg携带率仍达7.18%。在严格控制血源和医源性传播的情况下,浦江县近年乙肝报告发病率也是稳中有升,推测必有其他的危险因素在起作用。而从业人员作为一个特殊群体,虽然目前取消了岗前乙肝检测,但他们的感染对服务对象的健康影响却不能因此而忽视。目的：了解浦江县食品、公共场所从业人员乙肝感染状况及感染危险因素的分布特征,进一步检验传统的危险因素,探索从业人员是否有特殊的高危因素,为制定取消从业人员乙肝体检后的人群乙肝防控策略提供参考依据。方法：对浦江县2009年从业人员体检资料进行整理,进行描述性流行病学分析,掌握体检总人数、HBsAg阳性数、大三阳(HBsAg、HBeAg、HBcAb阳性)人数、小三阳(HBsA、HBeAb、HBcAb阳性)人数和乙肝三系(HBsAg、HBsAb、HBeAg、HBeAb、HBcAb)五项全阴人数等指标；以HBsAg阳性作为乙肝感染的指标,从感染者中按系统抽样法随机选取200名作为病例,以200名乙肝三系五项全阴人员作为对照,进行成组病例对照研究,对照组与病例组在性别、年龄等构成上差异无统计学意义。由培训合格的调查员入户进行个人社会学特征、免疫史、家庭感染情况、日常生活习惯等方面的调查,调查表当场收回,失访对象由系统抽样200名以外对象补足。所有个案统一编码,用Epidata3.1建立数据库,利用SPSS16.0统计软件包对数据进行统计分析,先将每一个可能的危险因素与乙肝感染进行单因素分析,初步筛选变量,然后对筛选出的变量进行多因素非条件logistic回归分析,用Forward:Wald法得出最佳拟合模型。结果：浦江县2009年食品、公共场所从业人员共体检6878人,HBsAg阳性435人,阳性率为6.32%,其中男性3398人,阳性率为6.95%,女性3480人,阳性率为5.72%,男女阳性率差异具有统计学意义(χ2=4.368,P0.05)。以10岁为一个年龄段划分,30岁-感染率最高,但各年龄组感染率差异无显著性。435名乙肝感染者中,小三阳人数最多,共258人,占所有感染者的59.31%,其次为大三阳感染者,占15.63%,感染者年龄最小为18岁,年龄最大60岁。病例组家庭成员乙肝感染以母亲为主,占43.8%,对照组则以父亲为主,占37.1%。经单因素分析,家庭成员有乙肝感染、牙科手术史、在外就餐、共用牙刷等生活用品、创伤性美容、经常流动成为乙肝感染的可能危险因素,饮用白酒P值临界(P=0.052),接种乙肝疫苗为保护性因素(χ2=28.108,P0.01)。将单因素筛选出的危险因素、接种疫苗及饮用白酒,采用Forward:Wald法进行多因素非条件Logistic回归分析,家庭成员有乙肝感染、牙科手术史、在外就餐、经常流动、接种疫苗进入方程,其OR值分别为3.548、2.978、4.675、4.492、0.143。结论：浦江县2009年共计体检食品、公共场所从业人员6878人,HBsAg阳性率(HBV感染率)为6.32%,低于金华市区不同人群乙肝感染率(浦江县为金华下属县),从业人员HBsAg阳性率男性高于女性,但各年龄段HBV感染率差异无显著性。单因素分析表明,浦江县从业人员乙肝感染的可能危险因素有：家庭成员乙肝感染、牙科手术、共用水杯等生活用品、经常在外就餐、创伤性美容、经常流动。多因素分析表明家庭成员乙肝感染、牙科手术、经常流动和在外就餐是我县食品、公共场所从业人员乙肝感染的主要危险因素,接种乙肝疫苗为保护性因素。
[Abstract]:Background : Hepatitis B is a worldwide disease caused by hepatitis B virus ( HBV ) . In five kinds of viral hepatitis , hepatitis B is the most serious harm to human health . The prevalence of hepatitis B infection has become one of the major public health problems in our country . In 2006 , the incidence of hepatitis B infection in Pujiang county is still 7.18 % .

Objective : To understand the distribution characteristics of hepatitis B infection and risk factors in food and public places in Pujiang County , to further test the traditional risk factors , to explore the special high risk factors of practitioners , and to provide a reference for the development of hepatitis B prevention and control strategy after the examination of hepatitis B .

Methods : A descriptive epidemiological analysis was carried out on the physical examination data of practitioners in Pujiang County in 2009 . The number of total physical examination , the number of HBsAg positive , the number of HBsAg , HBeAg , anti - Ab positive , the number of HBsAg , HBeAg , anti - Ab positive , the number of HBsAg , HBsAg , HBsAg , HBsAg , HBsAg , HBsAg , HBsAg , HBsAg , HBsAg , HBsAg , HBsAg , HBsAg , HBsAg , HBsAg , HBsAg , HBsAg , HBsAg , HBsAg , HBsAg , HBsAg , HBsAg , HBsAg , HBsAg , HBsAg , HBsAg , HBsAg , HBsAg , HBsAg , HBsAg , HBsAg , HBsAg , HBsAg , HBsAg , HBsAg , HBsAg , HBsAg , HBsAg , HBsAg , HBsAg , HBsAg , HBsAg , HBsAg , HBsAg , HBsAg , HBsAg , HBsAg , HBsAg , HBsAg , HBsAg , HBsAg , HBsAg , HBsAg , HBsAg , HBsAg , HBsAg , HBsAg , HBsAg , HBeAg and HBeAg were analyzed .
In this paper , 200 patients with hepatitis B infection were randomly selected from the infected persons by systematic sampling method , and 200 patients with hepatitis B were randomly selected as control groups .

Results : In 2009 , there were 6878 people in Pujiang County and 435 in public places . The positive rate was 6.32 % . Among them , the positive rate was 6.95 % , the positive rate was 5.72 % , the positive rate of male and female was 5.72 % , and the positive rate of male and female was statistically significant ( 蠂2 = 4.368 , P0.05 ) . Among 435 patients with hepatitis B infection , there were 258 people , accounting for 59.31 % of all infected persons , accounting for 15.63 % . The risk factors of single factor screening , vaccination and drinking liquor were analyzed by Forward : Wald method . The family members had hepatitis B infection , dental surgery history , external dining , regular flow and vaccination into the equation . The OR values were 3.548 , 2.978 , 4.675 , 4.492 , 0.143 , respectively .

Conclusion : The total HBsAg positive rate ( HBV infection rate ) is 6.32 % in Pujiang county in 2009 , and the positive rate of HBsAg ( HBV infection rate ) is 6.32 % . There is no significant difference in HBV infection rate among different people in Pujiang County . The single factor analysis indicates that the risk factors of HBV infection among family members are as follows : family member B infection , dental surgery , common water cup and other daily necessities . The analysis shows that hepatitis B infection , dental surgery , regular flow and external dining are the main risk factors of hepatitis B infection in our county , and the hepatitis B vaccine is taken as protective factor .

【学位授予单位】：浙江大学
【学位级别】：硕士
【学位授予年份】：2011
【分类号】：R181.3

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