| 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 Name | Affiliation | E-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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