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目的为更好地了解广州市越秀区居民病毒性肝炎的感染状况,分析影响因素,为探讨社区居民肝炎防控综合措施提供科学依据。方法采用分层整群随机抽样的方法,于2010年在广州市越秀区随机抽取一定数量的住户,对住户中全部人口共3 511人现场采集血样并用自制问卷调查患病史及疫苗接种史等,使用酶联免疫法检测肝炎血清学标志。结果调查人群抗-HAVIgG、抗-HCVIgG、HBsAg、抗-HBs、抗-HBc阳性率分别为91.83%、0.74%、7.18%、61.75%、17.23%。抗-HBc阳性率在各年龄组间差异有统计学意义(χ2=60.090,P<0.001),呈随年龄增长而增长趋势。HAV易感率为8.17%,其中19~岁组人群最低,与另两组别差异有统计学意义(χ2=17.620,P<0.01)。HBV易感率为21.47%,1~8岁组人群最低,9~18岁组人群最高,差异有统计学意义(χ2=6.970,P<0.05)。HCV易感率为99.26%,各年龄组间差异无统计学意义(χ2=0.005,P>0.05)。存在各型重叠感染的情况,各组合间感染率差异有统计学意义(χ2=1 556.978,P<0.01)。结论人群甲肝抗体水平较高,丙肝较低,乙肝仍有一定的易感人群,提示要继续巩固国家免疫规划儿童甲肝和新生儿乙肝疫苗接种,探讨青少年乙肝疫苗加强免疫、重点人群乙肝疫苗接种的可行性及落实健康教育、管理传染源等肝炎社区综合防控措施。
Objective To understand the status of viral hepatitis infection among residents living in Yuexiu District of Guangzhou City and to analyze the influencing factors so as to provide a scientific basis for the comprehensive prevention and control of hepatitis in community residents. Methods A stratified cluster random sampling method was used to randomly select a certain number of households in Yuexiu District of Guangzhou City in 2010. A total of 3 511 people were enrolled in the survey. Blood samples were collected on-site with a self-made questionnaire and their history and history of vaccination , Using enzyme-linked immunosorbent assay hepatitis serological markers. Results The positive rates of anti-HAVIgG, anti-HCVVIg, HBsAg, anti-HBs and anti-HBc were 91.83%, 0.74%, 7.18%, 61.75% and 17.23% respectively. The positive rate of anti-HBc in all age groups was statistically significant (χ2 = 60.090, P <0.001), showing an increasing trend with age. The susceptibility rate of HAV was 8.17%, of which the lowest in 19 ~ age group and the other two groups were statistically significant (χ2 = 17.620, P <0.01). The susceptibility rate of HBV was 21.47%, the lowest was in the group of 1 to 8 years old, the highest was in the group of 9 to 18 years old, the difference was statistically significant (χ2 = 6.970, P <0.05). The susceptibility rate of HCV was 99.26%. There was no significant difference among all age groups (χ2 = 0.005, P> 0.05). There were various types of overlap infection, the infection rate was statistically significant (χ2 = 1 556.978, P <0.01). Conclusions There is a high level of hepatitis A antibody in the population and a low level of hepatitis C, and there is still a certain susceptible population of hepatitis B. It is suggested that vaccination of hepatitis A and neonatal hepatitis B in children with the national immunization program should continue to be strengthened and hepatitis B vaccination of young people should be strengthened. Feasibility and implementation of health education, management of infectious diseases and other hepatitis community comprehensive prevention and control measures.