Abstract
朱立国,姜洁,宋词,邹艳,徐建芳,刘红建,彭红,胡志斌,朱凤才,沈洪兵,翟祥军.江苏省2012-2014年HBV携带者进展为慢性乙型肝炎患者的队列特征分析[J].Chinese journal of Epidemiology,2016,37(11):1463-1467
江苏省2012-2014年HBV携带者进展为慢性乙型肝炎患者的队列特征分析
A cohort study of hepatitis B virus carriers progressing to chronic hepatitis in Jiangsu province, 2012-2014
Received:June 02, 2016  
DOI:10.3760/cma.j.issn.0254-6450.2016.11.006
KeyWord: 乙型肝炎病毒携带者  慢性乙型肝炎  特征  队列
English Key Word: HBV Carrier  Chronic hepatitis B  Characteristics  Cohort
FundProject:国家科技重大专项(2009ZX10004-904;2011ZX10004-902;2013ZX10004-905);国家自然科学基金(81502861)
Author NameAffiliationE-mail
Zhu Liguo Major Project Executive Office, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing 210009, China  
Jiang Jie Major Project Executive Office, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing 210009, China  
Song Ci School of Public Health  
Zou Yan Epidemic Prevention Section, Zhangjiagang City Center for Disease Control and Prevention, Zhangjiagang 215600, China  
Xu Jianfang Epidemic Prevention Section, Danyang City Center for Disease Control and Prevention, Danyang 212310, China  
Liu Hongjian Major Project Executive Office, Taixing City Center for Disease Control and Prevention, Taixing 225400, China  
Peng Hong Major Project Executive Office, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing 210009, China  
Hu Zhibin Animal Care Facility, Nanjing Medical University, Nanjing 210029, China  
Zhu Fengcai Major Project Executive Office, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing 210009, China  
Shen Hongbing School of Public Health  
Zhai Xiangjun Major Project Executive Office, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing 210009, China jszxj@jscdc.cn 
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Abstract:
      目的 了解HBV携带者进展为慢性乙型肝炎(慢性乙肝)患者的流行病学特征,为推进HBV携带者的社区规范管理提供依据。方法 2012-2014年对在江苏省传染病防治示范区HBV携带者队列开展定期随访,并行B超检查及ALT、HBsAg、抗-HBe,HBeAg、乙肝病毒核酸(HBV DNA)检测。通过Cox回归分析携带者进展为慢性乙肝的特征及影响因素,通过方差分析和配对t检验分析携带者进展为慢性乙肝时HBeAg变化特征与HBV DNA的关系。结果 2012年4 069例HBV携带者[平均年龄(52.0±12.8岁)]随访到2014年时1 444例进展为慢性乙肝,进展率为21.0/100人年。男性携带者慢性乙肝进展率(24.8/100人年)高于女性(18.4/100人年);HBV DNA<2 000 IU/ml的携带者慢性乙肝进展率为19.0/100人年,低于2 000~19 999 IU/ml者(23.7/100人年)、20 000~199 999 IU/ml者(31.1/100人年)和≥200 000 IU/ml者(33.8/100人年)。通过Cox回归分析,除性别外,HBV DNA是携带者进展为慢性乙肝的影响因素(P<0.05)。40.7%的HBeAg阳性携带者进展为慢性乙肝时发生了HBeAg转换,1.7%的HBeAg阴性携带者进展为慢性乙肝时发生了HBeAg阳转。结论 江苏省传染病防治示范区HBV携带者慢性乙肝进展率为21.0/100人年,建议对HBV携带者定期检查ALT、B超和HBV DNA,可提高早发现慢性乙肝的可能性。
English Abstract:
      Objective To understand epidemiological characteristics and influencing factors of hepatitis B virus (HBV) carriers progressing to chronic hepatitis B in Jiangsu, and provide evidence for regular management of HBV carriers. Methods From 2012 to 2014, a cohort study was conducted among the HBV carriers in an area in Jiangsu province. Association between HBV carriers'demographics, HBeAg level and HBV DNA detection result and incidence of chronic hepatitis B was analyzed by Cox regression analyses. Results In 2012, a total of 4 069 HBV carriers aged (52.0±12.8) years were surveyed. By 2014, chronic hepatitis B had developed in 1 444 cases, with the rate of 21.0/100 person-years. Cox regression analysis indicted that, in addition to gender, HBV DNA level was an important influencing factor for the incidence of chronic hepatitis B (P<0.05). In HBeAg positive carriers progressing to chronic hepatitis, 40.7% had HBeAg seroconversion, and reversion of HBeAg occurred in 1.7% of HBeAg negative carriers. Conclusion Chronic hepatitis B developed in more than 1/5 (21.0/100 person-years) of HBV carriers in the surveyed area in Jiangsu. It is suggested to conduct regular ALT, HBV DNA detection and B ultrasonic examination in HBV carriers for the early detection of chronic hepatitis B.
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