苏州市居民乙型肝炎血清流行病学调查

发布时间：2018-06-15 22:55

本文选题：乙型肝炎 + 血清流行病学　；参考：《苏州大学》2008年硕士论文

【摘要】： 目的:了解苏州市居民乙型肝炎病毒(HBV)的感染现状及流行特征;了解苏州市不同地区、不同人群乙型肝炎(乙肝)疫苗免疫接种情况;评价乙肝疫苗纳入儿童计划免疫策略后乙肝防制的效果,为政府部门进一步制定乙肝的防制措施提供科学依据。方法:(1)抽样方法:采用多级随机抽样法。在苏州市7区5县(市)范围内,抽取1个区和1个县(市),抽到的区作为城市调查点,抽到的县(市)作为农村调查点;在抽到的区、县(市)中分别抽取3个街道或2个乡镇;在每个抽到的街道、乡镇随机抽取1个居民委员会或1个村民委员会,作为调查现场;在每个调查现场按照1～4岁、5～14岁、15～59岁年龄组,分别以村庄、个体、家庭为单位,进行抽样,抽取足够的调查对象。(2)调查方法:对每个调查对象按统一调查表进行询问调查,同时采集静脉血,分离血清,低温保存,检测相关指标。(3)检测方法:用酶联免疫法(ELISA)检测乙肝病毒表面抗原(HBsAg)、乙肝病毒表面抗体(抗-HBs)和乙肝病毒核心抗体(抗-HBc)。检测在中国疾病预防控制中心病毒所进行,检测试剂采用厦门英科新创生物技术有限公司生产的ELISA试剂。(4)统计方法:所有资料录入EpiData3.1数据库后,用SPSS11.5软件进行统计处理和分析。结果:(1)人口学特征:调查对象涉及到不同地区、年龄、性别、文化程度、职业、婚姻等。其中城乡人口比为1:1.01;1～4岁、5～14岁、15～59岁年龄构成比分别为19.23%、29.75%和51.02%;男女性别比为1:1.06。(2)乙肝疫苗接种情况:苏州市居民平均乙肝疫苗接种率为50.64%;城市与农村人群乙肝疫苗接种率无显著性差异;15岁～以下儿童组乙肝疫苗接种率(75.58%)明显高于15岁～以上青少年成人组(26.71%)。(3)HBV感染标志血清流行病学特征:人群中HBsAg阳性率为5.45%(72/1321),抗-HBs阳性率为58.29%(770/1321),抗-HBc阳性率为23.69%(313/1321),HBV感染率为39.89%(527/1321)。城市与农村人群HBsAg阳性率无显著性差异;15岁~以下儿童组HBsAg阳性率明显低于15岁～以上青少年成人组,其中儿童组中1～4岁抗-HBs阳性率高于5～14岁组;人群中HBsAg阳性率男性高于女性,但15岁～以下人群性别间无显著性差异。结论:苏州市乙肝疫苗纳入儿童计划免疫后效果显著,有效降低了人群HBsAg携带率和HBV感染率,已经从高流行地区进入中流行地区(8%HBsAg阳性率≥2%);其中1992年乙肝疫苗纳入儿童计划免疫管理以后出生的15岁以下儿童HBsAg阳性率发生显著下降,特别是5岁以下人群下降幅度更加明显,初步实现WHO西太区制定的5岁以下儿童HBsAg阳性率控制在1%以下的目标;而15岁～以上青少年成人组HBsAg阳性率变化不明显;说明实施大规模乙肝疫苗接种是控制HBV感染最有效的措施,提示今后在重点做好计划免疫人群乙肝疫苗接种的同时,还应提高成人乙肝疫苗接种免疫。
[Abstract]:Objective: to understand the infection status and epidemic characteristics of hepatitis B virus (HBV) in Suzhou residents, to understand the immunization of hepatitis B vaccine in different regions and different populations in Suzhou, and to evaluate the effect of hepatitis B prevention after the hepatitis B vaccine included in the planned immunization strategy of children, and to provide the government departments to further develop the prevention measures for hepatitis B. Scientific basis.
Methods: (1) sampling method: using the multilevel random sampling method, 1 districts and 1 counties (cities) were extracted from 5 counties (cities) of 7 District of Suzhou, and the areas were taken as urban investigation points, and the counties (cities) were taken as rural investigation points; 3 streets or 2 townships were extracted from the counties (cities), and 1 townships were randomly selected in each street. The residents' committee or 1 villagers' committees were used as the investigation site, and at the site of each survey, the samples were sampled at the age of 1~4, 5~14, and 15~59 years old, taking the villages, individuals and families as units respectively. (2) the investigation method: every investigation object was investigated according to the unified questionnaire, and the venous blood was collected at the same time. Serum, cryopreservation and related indexes were detected. (3) detection methods: HBV surface antigen (HBsAg), HBV surface antibody (anti -HBs) and hepatitis B virus core antibody (anti -HBc) were detected by enzyme linked immunosorbent assay (ELISA). The detection reagent was carried out in China Center for Disease Control and Prevention (CDC), and the detection reagent was used in Xiamen British new creation biological technology. The ELISA reagent produced by limited company. (4) statistical method: after all data are input into EpiData3.1 database, SPSS11.5 software is used for statistical processing and analysis.
Results: (1) demographic characteristics: the respondents were involved in different areas, age, sex, education, occupation, marriage and so on. The ratio of urban and rural population was 1:1.01, 1~4 years old, 5~14 years old and 15~59 years old, respectively 19.23%, 29.75% and 51.02%; the sex ratio of men and women was 1:1.06. (2) hepatitis B vaccination: the average hepatitis B vaccine of Suzhou residents The inoculation rate was 50.64%, and there was no significant difference in the rate of hepatitis B vaccination among urban and rural population, and the rate of hepatitis B vaccination in children under 15 years to below (75.58%) was significantly higher than that of 15 years old adults (26.71%). (3) the sero epidemiological characteristics of HBV infection markers: the positive rate of HBsAg in the population was 5.45% (72/1321), and the positive rate of anti -HBs was 58.29% (770/ 1321) the positive rate of anti -HBc was 23.69% (313/1321), and the infection rate of HBV was 39.89% (527/1321). There was no significant difference in the positive rate of HBsAg in urban and rural population; the positive rate of HBsAg in children under 15 years old was significantly lower than that of adolescents aged 15 years and above, of which the positive rate of 1~4 years in children was higher than that of 5~14 years, and the positive rate of HBsAg in the population was male. It was higher than that of women, but there was no significant difference in gender between 15 and below.
Conclusion: the effect of hepatitis B vaccine in Suzhou was significant after children's planned immunization. The rate of HBsAg and HBV infection were effectively reduced. The positive rate of 8%HBsAg was more than 2% in the high epidemic area. In 1992, the positive rate of HBsAg in children under 15 years of age after hepatitis B vaccine was brought into children's planned immunization management. In particular, the decline of the population under 5 years of age was more obvious, and the HBsAg positive rate of children under 5 years of age under the age of WHO was controlled under 1%, while the positive rate of HBsAg in the young adults aged 15 years and above was not obvious; it indicated that the most effective measures to control HBV infection were the most effective measures to control HBV infection. In the future, we should focus on immunization with hepatitis B vaccine, and we should also improve adult hepatitis B vaccination.
【学位授予单位】：苏州大学
【学位级别】：硕士
【学位授予年份】：2008
【分类号】：R181.3

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