文章摘要
陈陶阳,曲春枫,姚红玉,陆玲玲,樊健,王宇婷,黄飞,陆建华,倪正平,樊春笋,张亚玮.启东乙型肝炎干预研究:2013年随访人群HBV感染及慢性肝病现患调查[J].中华流行病学杂志,2016,37(1):64-67
启东乙型肝炎干预研究:2013年随访人群HBV感染及慢性肝病现患调查
Long-term efficacy of neonatal hepatitis B vaccination against chronic hepatitis B virus infection and chronic liver disease: a cross-sectional study based on Qidong Hepatitis B Intervention Study
收稿日期:2015-06-15  出版日期:2016-01-12
DOI:10.3760/cma.j.issn.0254-6450.2016.01.013
中文关键词: 肝炎病毒,乙型;肝炎疫苗,乙型;慢性肝病;横断面研究
英文关键词: Hepatitis B virus;Hepatitis B vaccine;Chronic liver disease;Cross-sectional study
基金项目:国家科技重大专项(2012ZX10002008-001,003);江苏省科技支撑计划(BE2013657)
作者单位E-mail
陈陶阳 226200 江苏省启东市人民医院启东肝癌防治研究所病因室  
曲春枫 100021 北京, 中国医学科学院肿瘤医院分子肿瘤学国家重点实验室
100021 北京, 中国医学科学院肿瘤医院 免疫学研究室 
quchf@cicams.ac.cn 
姚红玉 226200 江苏省启东市人民医院启东肝癌防治研究所病因室  
陆玲玲 226200 江苏省启东市人民医院启东肝癌防治研究所病因室  
樊健 226200 江苏省启东市人民医院启东肝癌防治研究所病因室  
王宇婷 100021 北京, 中国医学科学院肿瘤医院分子肿瘤学国家重点实验室  
黄飞 226200 江苏省启东市人民医院启东肝癌防治研究所病因室  
陆建华 226200 江苏省启东市人民医院启东肝癌防治研究所病因室  
倪正平 226200 江苏省启东市人民医院启东肝癌防治研究所病因室  
樊春笋 226200 江苏省启东市人民医院启东肝癌防治研究所病因室  
张亚玮 226200 江苏省启东市人民医院启东肝癌防治研究所病因室
美国耶鲁大学公共卫生学院环境健康科学系 
 
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中文摘要:
      目的 分析新生儿接种乙型肝炎(乙肝)疫苗人群在达到婚配年龄后罹患慢性乙肝、肝硬化的远期保护作用。方法 2013年1-10月采用横断面调查方法,对启东乙肝干预研究(QHBIS)的研究对象分层随机抽样,并行ALT、HBV感染血清学标志物(HBsAg、HBeAg、抗-HBs、抗-HBc、抗-HBe)检测及肝胆B超检查。计算HBV感染血清学标志物各指标的阳性率,慢性乙肝及肝硬化的患病率,疫苗组及对照组人群按性别分层后, χ2检验比较各组间率的差异。结果 共获得新生儿乙肝疫苗接种组(疫苗组)4 421人和对照组3 880人,平均年龄分别为(25.59±1.84)岁和(26.61±2.24)岁。疫苗组HBsAg、单独抗-HBs、抗-HBc、HBeAg、抗-HBe阳性率分别为2.38%、37.73%、3.78%、0.57%、2.15%,对照组分别为9.02%、29.41%、16.83%、2.73%、8.87%,两组间血清学标志物各指标的差异均有统计学意义(P <0.05)。疫苗组慢性乙肝活动期、肝纤维化及肝硬化患病率分别为0.45%和0.16%,对照组分别为1.29%和0.39%,组间差异均有统计学意义(P <0.05)。按性别分层后,疫苗组男性慢性乙肝活动期患病率高于女性,差异有统计学意义(P <0.05);在对照组,不管是慢性乙肝活动期患病率还是肝纤维化及肝硬化患病率,男性均高于女性,差异有统计学意义(P <0.05)。结论 新生儿接种乙肝疫苗对慢性HBV感染的保护作用可延长至婚配年龄后,而不同性别人群慢性乙肝与肝硬化现患保护作用的差异值得进一步研究。
英文摘要:
      Objective To evaluate the long-term protection efficacy of neonatal hepatitis B vaccination on chronic hepatitis B (CHB) and liver fibrosis and cirrhosis in adults. Methods From January to October, 2013, a cross-sectional study was conducted among the participants from Qidong Hepatitis B Intervention Study (QHBIS), who were selected through stratified random sampling. The detections of serum alanine aminotransferase (ALT), HBsAg, anti-HBs, anti-HBc, HBeAg, and anti-HBe were conducted and ultrasonography on liver, gallbladder and spleen was performed for them. The positive rates of each serologic markers, the prevalence of active CHB and liver fibrosis and cirrhosis were calculated, the gender specific differences between vaccination group and control group were compared with Chi-square test. Results A total of 4 421 participants aged (25.59±1.84) years in vaccination group and 3 880 participants aged (26.61±2.24) years in control group were surveyed. The positive rates of HBsAg, anti- HBs, anti-HBc, HBeAg and anti-HBe were 2.38%, 37.73%, 3.78%, 0.57% and 2.15% in vaccination group, and 9.02%, 29.41%, 16.83%, 2.73% and 8.87% in control group, respectively, the differences between two groups were statistically significant (all P <0.05). The prevalence of active CHB and liver fibrosis and cirrhosis were 0.45% and 0.16% in vaccination group, 1.29% and 0.39% in control group, the differences between two groups were statistically significant (P <0.05). The active CHB prevalence was lower in females than in males in both vaccination group and control group (P <0.05). The liver fibrosis and cirrhosis prevalence was lower in females than in males in control group (P <0.05); whereas, no statistical significant difference in liver fibrosis & cirrhosis prevalence between males and females was found in vaccination group (P> 0.05). Conclusions Protection conferred by neonatal hepatitis B vaccination could last to marrying age. The gender specific difference in protection efficacy needs further study.
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