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目的 了解广东省病毒性肝炎流行现状,为制订防治策略提供科学依据。方法 2 0 0 2年7～8月采取分层多阶段随机抽样方法,全省分4层共抽取12个县,2 4个村,386 4人作为研究样本。用酶联免疫吸附试验(ELISA)检测抗甲型肝炎(甲肝)病毒(HAV)IgG、抗丙型肝炎(丙肝)病毒(HCV)IgG、抗 戊型肝炎(戊肝)病毒(HEV)IgG ;用固相放射免疫法(SPRIA)检测乙型肝炎(乙肝)病毒表面抗原(HBsAg)、乙肝病毒表面抗体(抗 HBs)和乙肝病毒核心抗体(抗 HBc)。结果 全省抗 HAV标化流行率6 9. 0 4 % ,乙肝病毒(HBV)标化流行率6 8 .94 % ,抗HCV标化流行率2 . 2 5 % ,抗HEV标化流行率7. 2 9%。甲、乙、丙肝标化流行率城市低于农村,戊肝标化流行率则城市高于农村;甲、乙、戊肝标化流行率都有随年龄增长而升高的趋势;甲肝标化流行率男性(5 0 . 92 % )低于女性(5 8 .73% )(P =0 . 0 0 0 ) ,乙、丙、戊肝标化流行率男、女性差异无显著的统计学意义。各型肝炎有混合感染:双重型混合感染占37. 78% ,3个型别、4个型别的混合感染分别占3 5. 5 %和0 . 14 %。结论 揭示了广东省病毒性肝炎的血清流行病学特征;乙肝疫苗纳入计划免疫管理10年,1～9岁儿童HBV感染率大幅度下降;广东省属甲肝中度流行区,提出全省甲肝的免疫控制策略建议。
Objective To understand the prevalence of viral hepatitis in Guangdong Province and provide a scientific basis for formulating prevention and control strategies. Methods From July to August 2002, a stratified and multi-stage random sampling method was adopted. There were 12 counties, 24 villages and 386 people in 4 layers in the province as research samples. The anti - hepatitis A (HAV) IgG, anti - hepatitis C (HCV) IgG and anti - HEV IgG were detected by enzyme - linked immunosorbent assay (ELISA) Hepatitis B virus surface antigen (HBsAg), hepatitis B virus surface antigen (anti-HBs) and hepatitis B virus core antibody (anti-HBc) were detected by solid phase radioimmunoassay (SPRIA). Results The prevalence of anti-HAV standardization in the province was 69.04%, the standardized prevalence of hepatitis B virus (HBV) was 68.94%, the anti-HCV prevalence was 2.25%, and the anti-HEV standardization rate was 7 2 9%. The prevalence rates of hepatitis A, B and C were lower in cities than in rural areas, and the epidemic rates of hepatitis E were higher in urban areas than those in rural areas. The prevalence rates of A, B and E hepatic diseases tended to increase with age. The prevalence of males (59.2%) was lower than that of females (58.73%) (P = 0.0000). There was no significant difference in the prevalence rates of hepatitis B, C and C between men and women . Mixed infection of various types of hepatitis: double mixed infection accounted for 37. 78%, 3 types, 4 types of mixed infections accounted for 35.5% and 0.14%. Conclusion The serological epidemiological characteristics of viral hepatitis in Guangdong Province were revealed. Hepatitis B vaccine was significantly reduced after 10 years of planned immunization management in children aged 1 to 9 years. Guangdong province was moderately infected with hepatitis A Immune control strategy recommendations.