中国2013-2020年乙型肝炎发病情况估算和病例特征分析

缪宁; 王富珍; 郑徽; 张国民; 尹遵栋

Abstract

缪宁,王富珍,郑徽,张国民,尹遵栋.中国2013-2020年乙型肝炎发病情况估算和病例特征分析[J].Chinese journal of Epidemiology,2021,42(9):1527-1531

中国2013-2020年乙型肝炎发病情况估算和病例特征分析

Estimation of incidence of viral hepatitis B and analysis on case characteristics in China,2013-2020

Received:March 19, 2021

DOI：10.3760/cma.j.cn112338-20210319-00227

KeyWord: 乙型肝炎发病估算特征

English Key Word: Hepatitis B Incidence Estimate Characteristics

FundProject:中国成人高危人群和社区人群乙肝疫苗优化免疫策略研究（2018ZX10721202）；中国慢性病毒性肝炎流行现状研究（2017ZX10105015）；2021年公共卫生应急反应机制的运行-计划免疫项目（131031001000200001）

Author Name	Affiliation	E-mail
Miao Ning	Department of National Immunization Program, Chinese Center for Disease Control and Prevention, Beijing 100050, China
Wang Fuzhen	Department of National Immunization Program, Chinese Center for Disease Control and Prevention, Beijing 100050, China
Zheng Hui	Department of National Immunization Program, Chinese Center for Disease Control and Prevention, Beijing 100050, China
Zhang Guomin	Department of National Immunization Program, Chinese Center for Disease Control and Prevention, Beijing 100050, China	zhanggm@chinacdc.cn
Yin Zundong	Department of National Immunization Program, Chinese Center for Disease Control and Prevention, Beijing 100050, China

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Abstract:

目的为了解我国乙型肝炎（乙肝）病例的发病特征，为评估我国消除乙肝目标的实现情况，制定乙肝防控规划提供科学依据。方法对2013-2020年我国高、中、低流行区的全国法定传染病报告系统（NNDRS）中报告的乙肝病例进行调查，分析报告的病例的诊断信息，通过报告信息和诊断信息对2013-2020年的乙肝病例发病情况进行估算。分析急性乙肝和慢性乙肝的病例特征。结果 NNDRS中共报告了27 013例病例，其中急性乙肝病例4 070例，慢性乙肝病例21 971例，未分类乙肝病例972例。报告急性乙肝病例中，诊断为急性乙肝的占69.9%（2 845/4 070），报告慢性乙肝病例中，诊断为急性乙肝的占2.1%（452/21 971），诊断为慢性乙肝的占89.0%（19 548/21 971）。通过对发病情况进行估算，2013-2020年全国估计急性乙肝发病率为4.6/10万，慢性乙肝发病率为54.5/10万。急性乙肝中以31~45岁组最多，占35.3%（1 164/3 297），≤ 15岁儿童仅占0.4%（13/3 297）。慢性乙肝中以46~60岁组最多，占34.4%（7 211/20 932）。结论我国急性乙肝发病率逐年下降，慢性乙肝发病率有上升趋势，应进一步加强对慢性乙肝的规范化诊断和治疗，降低因慢性乙肝导致的疾病转归和死亡的发生。同时需要对NNDRS中报告的乙肝病例报告进行规范化的管理和报告，以提高乙肝病例分类报告的准确性。

English Abstract:

Objective To understand the epidemiological characteristics of hepatitis B in China, evaluate the performance of elimination hepatitis B in China and provide scientific evidence for the prevention and control of hepatitis B. Methods An analysis was conducted by using the data of hepatitis B cases reported to the National Notifiable Disease Reporting System (NNDRS) from the areas with low, moderate and high hepatitis B prevalence in China from 2013 to 2020, and the information about the diagnoses of the hepatitis B cases were collected, the incidence of hepatitis B was estimated according to the reporting and diagnosis information and the characteristics of acute and chronic hepatitis B were compared. Results A total of 27 013 hepatitis B cases were reported to NNDRS, including 4 070 acute cases, 21 971 chronic cases and 972 unclassified cases. Among the reported acute hepatitis B cases, 69.9% (2 845/4 070) were confirmed. Among the reported chronic hepatitis B cases, 89.0% (19 548/21 971) were confirmed, and 2.1% (452/21 971) were confirmed as acute cases. It was estimated that the incidence of acute hepatitis B was 4.6/100 000 and the incidence of chronic hepatitis B cases was 54.5/100 000. The case number of acute hepatitis B in age group 31-45 years was highest, accounting for 35.3% (1 164/3 297). The case number of acute hepatitis B in children under 15 years old was lowest, accounting for 0.4% (13/3 297). The case number of chronic hepatitis B in age group 46-60 years was highest, accounting for 34.4% (7 211/20 932). Conclusions The incidence of acute hepatitis B was in decrease and the incidence of chronic of hepatitis B was in increase in China year by year. It is important to strengthen the standardized diagnosis and treatment of chronic hepatitis B to decrease the morbidity and mortality of hepatitis B. At the same time, it is necessary to standardize the management and reporting of hepatitis B cases reported to NNDRS to improve the accuracy of the reporting of hepatitis B.

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