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目的通过分析扬州市2004-2012年戊型病毒性肝炎(戊肝)的发病趋势和病例对照研究,探讨人群戊型肝炎病毒(Hepatitis E Virus,HEV)感染的危险因素,提供有效的戊肝控制策略。方法对扬州市2004-2012年戊肝疫情资料进行流行病学对比分析;以134例戊肝患者为病例组,以与病例条件相似的268名健康者为对照组,进行1∶2配对病例对照研究,收集流行病学史、相关卫生行为等资料,采用单因素、多因素COX回归等分析戊肝发病的危险因素。结果戊肝发病上升趋势明显,2~3月出现相对发病高峰;病例年龄以中老年、职业以农民、文化程度以初中以下为主,生活环境差;单因素分析与戊肝发病相关的危险因素表明,肝炎病人接触史、猪类接触史、医疗史3个因素差异有统计学意义;多因素分析显示,差异有统计学意义的危险因素有既往肝炎史(OR=3.57,95%CI:2.40~85.42)、猪类接触史(OR=7.21,95%CI:1.65~31.45)、生食瓜果蔬菜史(OR=2.95,95%CI:1.19~7.36)、医疗史(OR=6.23,95%CI:2.82~13.78)。结论患者防病意识普遍较低,应结合戊肝的流行特点开展相关防制工作,加强戊肝防控的健康教育和重点人群的保护。
Objective To analyze the incidence trend of hepatitis E (hepatitis E) and case-control study in Yangzhou City from 2004 to 2012 to explore the risk factors of hepatitis E virus (HEV) infection in the population and provide effective hepatitis E control Strategy. Methods Epidemiological comparative analysis of epidemic situation of hepatitis E from 2004 to 2012 was conducted in Yangzhou City. A total of 134 cases of hepatitis E patients were selected as the case group and 268 healthy subjects as the control group. Research, collection of epidemiological history, related health behaviors and other data, the use of univariate, multivariate COX regression analysis of risk factors for hepatitis E pathogenesis. Results The incidence of hepatitis E increased significantly, with a relative incidence peak from February to March. The age of the patients was middle-aged and old and the occupation was farmer. The education level was lower than junior high school, living environment was poor. Univariate analysis showed that the risk factors related to hepatitis E The results showed that there were significant differences among the three groups in history of exposure to hepatitis, history of exposure to pigs, and history of medical treatment. Multivariate analysis showed that the statistically significant risk factors were previous history of hepatitis (OR = 3.57, 95% CI: 2.40 ~ 85.42), pig history (OR = 7.21, 95% CI: 1.65 ~ 31.45), raw vegetables and fruits (OR = 2.95,95% CI: 1.19 ~ 7.36) CI: 2.82 ~ 13.78). Conclusion The awareness of disease prevention in patients is generally low. Relevant prevention and control work should be carried out in accordance with the epidemiological characteristics of hepatitis E, and the health education of prevention and control of hepatitis E and the protection of key populations should be strengthened.