| 崔富强,卢永,王富珍,陈园生,郑徽,张勇,龚晓红,韩丽丽,董红军,陈超,凌罗亚,张丽,刁琳琪,邵晓萍,方刚,高丽,梁晓峰.中国2006年乙型肝炎报告病例构成分析[J].Chinese journal of Epidemiology,2007,28(9):872-874 |
| 中国2006年乙型肝炎报告病例构成分析 |
| Analysis on the proportion of reported hepatitis B cases through pilot surveillance in China during 2006 |
| Received:May 10, 2007 Revised:September 10, 2007 |
| DOI： |
| KeyWord: 乙型肝炎 监测 病例构成 |
| English Key Word: Hepatitis B Surveillance Proportion |
| FundProject:国家“十五”科技攻关课题资助项目(2004BA718B01) |
| Author Name | Affiliation | E-mail | | CUI Fu-qiang | National Immunization Programme, Chinese Center for Disease Control and Prevention, Beijing 100050, China | | | LU Yong | National Immunization Programme, Chinese Center for Disease Control and Prevention, Beijing 100050, China | | | WANG Fu-zhen | National Immunization Programme, Chinese Center for Disease Control and Prevention, Beijing 100050, China | | | CHEN Yuan-sheng | National Immunization Programme, Chinese Center for Disease Control and Prevention, Beijing 100050, China | | | ZHENG Hui | National Immunization Programme, Chinese Center for Disease Control and Prevention, Beijing 100050, China | | | ZHANG Yong | 陕西省疾病预防控制中心 | | | GONG Xiao-hong | 中国疾病预防控制中心病毒病预防控制所 | | | HAN Li-li | 北京市疾病预防控制中心 | | | DONG Hong-jun | 北京市疾病预防控制中心 | | | CHEN Chao | 宁波市疾病预防控制中心 | | | LING Luo-ya | 吉林省疾病预防控制中心 | | | ZHANG Li | 浙江省疾病预防控制中心 | | | DIAO Lin-qi | 山东省疾病预防控制中心 | | | SHAO Xiao-ping | 河南省疾病预防控制中心 | | | FANG Gang | 广东省疾病预防控制中心 | | | GAO Li | 四川省疾病预防控制中心 | | | LIANG Xiao-feng | 甘肃省疾病预防控制中心 | liangxf@hotmail.com |
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| Abstract: |
| 目的对监测点报告乙型肝炎(乙肝)病例进行调查和实验室复核,掌握监测点乙肝报告病例的构成。方法对18个监测点所有符合病例定义报告的乙肝疑似病例进行调查,采血和实验室复核甲肝抗体(抗-HAV)、乙肝病毒表面抗原(HBsAg)和乙肝病毒核心抗体(抗-HBc)的IgM。最终进行实验室诊断。结果2006年8省市18个县监测点共报告2858例乙肝病例,其中急性疑似病例占23.97%,急性确诊病例占14.87%,慢性疑似病例占20.33%,慢性确诊病例占34.67%,肝硬化占4.09%,原发性肝癌占2.06%。对1681例进行了实验室复核,复核后急性乙肝病例占24.16%,急性确诊病例占15.37%。尽管急性和慢性乙肝病例复核前后比例变化不大,但复核前后一致性较低。结论国内乙肝报告病例中以慢性乙肝病例为主,急性乙肝病例在报告的乙肝病例中能够准确判定的病例仅占不足1/3。报告的乙肝病例存在分类错误,不能客观反映乙肝发病水平。修订国家乙肝诊断标准,对乙肝病例开展监测,将急性乙肝和慢性乙肝病例分别报告是监测系统亟需解决的问题。 |
| English Abstract: |
| Objective To better understand the proportions of reported hepatitis B cases in pilot surveillance cites through investigation and laboratory testing.Methods To confirm the reported cases of hepatitis B by collecting blood specimen and laboratory testing on HBsAg,lgM of Anti-HBc,Anti-HAV in 18 pilot surveillance counties.Results Among 2858 eases of hepatitis B reported in 2006,23.97 % of them were reported as suspected acute cases,14.87% as acute cases,20.33% as suspected chronic cases,34.67% as chronic cases,4.09% as cirrhosis and 2.06% as HCC.Among 1681 reported hepatitis B cases confirmed by laboratory testing,results showed that 24.16% of them were diagnosed as acute hepatitis B,but only 15.37% were confirmed as acute hepatitis B.Although the proportion confirmed as hepatitis B kept consistent as before, miselassification was found.Conclusion In current surveillance system,reported hepatitis B cases were mainly chronic,only up to one third belonged to acute hepatitis B.The reported incidence of hepatitis B did not reflect the real incidence due to misclassification.To better define the burden on hepatitis B disease,it was necessary and urgent to revise the diagnostic criteria and to conduct surveillance on hepatitis B,under separate reporting categories which including acute and chronic cases of the disease. |
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