丙型肝炎病毒感染危险因素的病例对照研究

发布时间：2018-06-23 20:51

本文选题：丙型肝炎 + 危险因素　；参考：《中国疾病预防控制中心》2014年硕士论文

【摘要】：目的了解丙型肝炎病毒(简称HCV)感染者的基本情况以及探索HCV感染的危险因素,确定HCV感染的主要危险因素,为卫生决策者制定丙型肝炎防治策略策略提供参考依据。方法2013年6月～10月,在两省的18所医院进行1：1个体匹配的病例对照研究,研究对象包括病例组和对照组,将符合纳入标准的HCV感染者作为病例组和非HCV感染者作为对照组,通过一对一的问卷调查,收集200对病例和对照的资料,运用描述性统计学方法分析HCV感染者的基本情况,利用单因素和多因素条件logistic回归分析方法,探讨HCV感染的主要危险因素。结果 1.本次研究共调查了200例HCV感染者,年龄范围为18～80岁,平均52.6±12.4岁,HCV感染者主要集中在40～49岁(22.5%)、50～59岁(33.0%)和60-69岁(25.0%)年龄段。93.0%HCV感染者已婚或同居；小学和初中文化水平者较多,分别占33.0%、33.0%；200例HCV感染者中有创伤性美容史、共用剃须刀史、性病史、性伴中有丙型肝炎者、吸毒史等危险因素的感染者,分别占13.5%、4.5%、3.0%、2.0%、2.0%；有手术史、牙科诊疗史、侵入性诊疗、献血史、输血史、输血制品史、玻璃注射器/可换针头的输液器注射史、血液透析史等危险因素的感染者,分别占64.0%、41.0%、39.5%、30.5%、30.5%、12.0%、9.0%、2.0%。 2.为了探索HCV感染的危险因素,本研究同时对200例非HCV感染者进行了配对调查,经过单因素条件logistic回归分析显示,献血、献血次数及地点,输血及输血地点,玻璃注射器/可换针头的输液器注射史,输血制品,手术、手术次数及地点,牙科诊疗地点及侵入性诊疗等因素与HCV感染有统计学关联。 3.为了确定HCV感染的主要危险因素,将单因素分析结果P0.1的变量纳入到条件多因素分析模型中,采用条件logistic逐步回归分析方法筛选HCV感染的主要危险因素。研究结果显示,1998年及以前献血史(OR=83.6,95%CI：9.6-728.3)、1998年及以前输血史(OR=26.8,95%CI：5.0-143.9)、玻璃注射器/可换针头输液器注射史(OR=25.5,95%CI：1.6-396.0)、集市街头/个体诊所牙科诊疗史(OR=3.2,95%CI：1.2-8.0)、2006年以前手术史(OR=2.6,95%CI：1.2-5.5)是HCV感染的主要危险因素。结论针对HCV既往感染的危险因素建议继续监督落实血液筛查等国家防控策略等,积极有效地防控HCV的进一步传播和蔓延。针对不安全注射及牙科诊疗,要加强对医护人员的培训,规范医护人员的医疗操作行为,同时也要加强对大众的宣传教育,提高其预防疾病意识,另外卫生监督部门应加大基层医疗卫生的监督力度,杜绝通过不安全注射及牙科诊疗造成HCV的传播。
[Abstract]:Objective to understand the basic situation of hepatitis C virus (HCV) infection and explore the risk factors of HCV infection, to determine the main risk factors of HCV infection, and to provide a reference for health decision makers to formulate prevention and treatment strategies for hepatitis C. Methods from June to October 2013, a 1:1 matched case-control study was conducted in 18 hospitals in the two provinces. The subjects included the case group and the control group. According to the inclusion criteria, HCV infection was used as case group and non-HCV infection group as control group. Through one-to-one questionnaire, 200 pairs of case and control data were collected, and the basic situation of HCV infection was analyzed by descriptive statistical method. Univariate and multivariate conditional logistic regression analysis was used to study the main risk factors of logistic infection. Result 1. A total of 200 patients with HCV infection were investigated in this study. The age ranges from 1860 to 80 years, with an average of 52.6 卤12.4 years of age. The majority of patients with HCV infection were 40 to 49 years old (22.5%), 5059 years old (33.0%) and 60-69 years old (25.0%). Among 200 patients with HCV infection, 33.0% had a history of traumatic beauty, a history of sharing razors, a history of sexual illness, a history of hepatitis C in sexual partners, and a history of drug abuse, accounting for 13.54.50% of the infected persons with dangerous factors such as 2.0% 2.0.The patients had a history of surgery, a history of dental treatment, and a history of invasive diagnosis and treatment. The history of blood donation, the history of blood transfusion products, the history of injection of glass syringes / transfusible needles, the history of hemodialysis and other risk factors were 64.0%, 41.0% and 39.5%, respectively. In order to explore the risk factors of HCV infection, a matched study was conducted in 200 patients with non-HCV infection. Univariate conditional logistic regression analysis showed that the number and location of blood donation, blood transfusion and blood transfusion location. The history of injection of glass syringe / transfusible needle, transfusion products, times and location of operation, dental diagnosis and treatment site and invasive diagnosis and treatment were associated with HCV infection. 3. In order to determine the main risk factors of HCV infection, the variable P0.1 of single factor analysis was incorporated into the conditional multivariate analysis model, and the main risk factors of HCV infection were screened by conditional logistic stepwise regression analysis. The results show that the history of blood donation in 1998 and before (ORI 83.6 / 95CI: 9.6-728.3), the history of blood transfusion in 1998 and before (OR26.895 CI: 5.0-143.9), the history of injection of glass syringes / exchangeable needles (OR-25.5CI-95: 1.6-396.0), the history of dental treatment in street / individual clinics (OR3.2995 CI: 1.2-8.0), the history of surgery before 2006 (OR2.695CI) % 1.2-5.5) is the main risk factor for HCV infection. Conclusion in view of the risk factors of HCV infection in the past, we should continue to supervise and implement national prevention and control strategies such as blood screening, and actively and effectively prevent and control the further spread and spread of HCV. In view of unsafe injection and dental diagnosis and treatment, we should strengthen the training of medical staff, standardize the medical operation behavior of medical staff, at the same time, we should strengthen publicity and education to the public and raise their awareness of disease prevention. In addition, the health supervision department should strengthen the supervision of primary health care and prevent the transmission of HCV through unsafe injection and dental treatment.
【学位授予单位】：中国疾病预防控制中心
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R512.63

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