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目的 分析广西壮族自治区南宁市维持性血液透析患者乙型肝炎病毒(HBV)感染与免疫状况,并探讨相关影响因素.方法 采用面对面问卷调查和病历采集的方式收集3所医院血液透析中心维持性血液透析患者一般情况、血液透析相关资料、行为危险因素、乙型病毒性肝炎(乙肝)疫苗接种史及乙肝家族史等.采集研究对象5 ml静脉血,使用化学发光免疫试验检测患者血清乙肝表面抗原(HBsAg)与乙肝表面抗体(抗-HBs);采用横断面研究与病例对照研究的方法分析HBV感染与免疫状况及相关影响因素.结果 本次研究共纳入研究对象628例,HBsAg阳性率为10.19%(64/628),抗-HBs阳性率为66.88%(420/628).HBsAg阴性的患者抗-HBs平均浓度、阳性率及强阳性率均高于HBsAg阳性的患者,且差异均具有统计学意义(P<0.01).血液透析患者乙肝疫苗接种率27.39%(172/628),抗-HBs阳性患者乙肝疫苗接种率高于抗-HBs阴性患者,差异具有统计学意义(P=0.013).采用非条件Logistic回归分析HBsAg及抗-HBs影响因素,结果显示,有乙肝家族史者HBsAg阳性的风险是无家族史者的3.19倍[OR=3.186,95%CI(1.713,11.029)];贫血患者HBsAg阳性的风险是非贫血患者的5.03倍[OR=5.028,95%CI(2.185,18.534)].HBsAg阳性患者抗-HBs阴性的风险是HBsAg阴性患者的6.54倍[OR=6.536,95%CI(2.817,15.152)].结论 维持性血液透析患者HBsAg阳性率较高,应进一步加强患者乙肝血清学定期筛查并提高乙肝疫苗接种率,提高该人群保护性抗体水平,降低其HBV感染风险.“,”Objective To determine the HBV infection and immune status in maintenance hemodialysis pa-tients in Nanning of Guangxi Zhuang Autonomous Region, and to investigate the influencing factors. Methods The general demographic characteristics, related data of hemodialysis, behavioral risk factors, history of hepatitis B vacci-nation and family history of hepatitis B of maintenance hemodialysis patients, who were hospitalized in three hospitals, were collected by face-to-face questionnaire interviews and medical records. Venous blood 5 ml in each subject was collected, and the serum HBsAg and anti-HBs were determined by chemiluminescence immunoassay. The HBV infec-tion and immune status and their influencing factors were determined by cross-sectional study and case-control study. Results A total of 628 subjects were included in this study. The positive rate of HBsAg and anti-HBs was 10.19%(64/628) and 66.88% (420/628), respectively. The mean concentration, positive rate and high-level positive rate in HBsAg-negative patients were higher than those in HBsAg-positive patients, and the differences were statistically sig-nificant (P<0.01). The hepatitis B vaccination rate in hemodialysis patients was 27.39% (172/628). The hepatitis B vaccination rate in anti-HBs positive patients was higher than that in anti-HBs negative patients, and the difference was statistically significant (P=0.013). The influencing factors of HBsAg and anti-HBs were analyzed by unconditional logistic regression, and the findings showed that the risk of HBsAg positive in patients with family history of hepatitis B was 3.19 times that of patients with no family history of hepatitis B [OR=3.186, 95%CI(1.713, 11.029)];the risk of HBsAg positive in anemic patients was 5.03 times that of non-anemic patients [OR=5.028, 95% CI(2.185, 18.534)]. The risk of anti-HBs negative in HBsAg-positive patients was 6.54 times that of HBsAg-negative patients [OR=6.536,95%CI(2.817, 15.152)]. Conclusion The positive rate of HBsAg in maintenance hemodialysis patients is high, and we should further strengthen regular screening of hepatitis B serology and improve hepatitis B vaccination rate to in-crease the level of protective antibody and decrease the risk of HBV infection.