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预防医学  2025, Vol. 37 Issue (12): 1272-1276    DOI: 10.19485/j.cnki.issn2096-5087.2025.12.017
  疾病控制 本期目录 | 过刊浏览 | 高级检索 |
嘉兴市医疗机构就诊者乙型病毒性肝炎血清流行病学调查
刘敏琪1, 葛锐1, 侯志刚1, 茅蓉1, 高慧1, 吴大明1, 戴林晔2
1.嘉兴市疾病预防控制中心,浙江 嘉兴 314050;
2.海宁市疾病预防控制中心,浙江 海宁 314400
Seroepidemiological of hepatitis B among outpatients in medical institutions in Jiaxing City
LIU Minqi1, GE Rui1, HOU Zhigang1, MAO Rong1, GAO Hui1, WU Daming1, DAI Linye2
1. Jiaxing Center for Disease Control and Prevention, Jiaxing, Zhejiang 314050, China;
2. Haining Center for Disease Control and Prevention, Haining, Zhejiang 314400, China
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摘要 目的 了解浙江省嘉兴市医疗机构就诊者乙型病毒性肝炎(乙肝)血清流行病学特征,为制定区域乙肝防治策略提供参考。方法 于2024年4—6月,选择嘉兴市哨点医疗机构就诊者为调查对象,收集性别、年龄等资料;采集静脉血,检测乙肝表面抗原(HBsAg)、乙肝表面抗体(HBsAb)、乙肝e抗原(HBeAg)、乙肝e抗体(HBeAb)和乙肝核心抗体(HBcAb);分析不同性别、年龄乙肝病毒(HBV)血清标志物阳性率。结果 纳入1 468名就诊者,其中男性721人,占49.11%;女性747人,占50.89%。年龄为(46.41±19.66)岁。HBsAg、HBsAb、HBeAg、HBeAb和HBcAb阳性率分别为7.29%、44.75%、1.84%、23.50%和42.03%。男性HBcAb阳性率为46.05%,高于女性的38.15%(P<0.05);其他4种血清标志物阳性率性别差异无统计学意义(均P>0.05)。除HBsAb外,其他4种血清标志物阳性率在不同年龄组差异有统计学意义(均P<0.05);两两比较结果显示,20~<40岁和40~<60岁组HBsAg阳性率分别为9.48%和9.57%,高于<20岁组的1.43%和≥60岁组的2.75%(均P<0.05)。存在17种HBV血清标志物组合,其中全阴性比例较高,为39.65%;“小三阳”和“大三阳”比例分别为4.77%和1.50%。HBsAg阳性者中,不同年龄组“小三阳”比例分别为0、45.45%、90.00%和81.82%,“大三阳”比例分别为0、36.36%、5.00%和0,差异有统计学意义(均P<0.05)。结论 嘉兴市医疗机构就诊者HBsAg阳性率较高,免疫空白及无应答者较多。建议加强20~<60岁人群乙肝免疫预防,强化“小三阳”和“大三阳”人群监测与干预治疗。
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刘敏琪
葛锐
侯志刚
茅蓉
高慧
吴大明
戴林晔
关键词 乙型病毒性肝炎乙型肝炎病毒血清标志物血清流行病学    
AbstractObjective To investigate the seroepidemiological characteristics of hepatitis B among outpatients in medical institutions in Jiaxing City, Zhejiang Province, so as to provide a reference for formulating region-specific hepatitis B prevention and control strategies. Methods From April to June 2024, outpatients were selected as study subjects from sentinel medical institutions in Jiaxing City. Information such as gender and age was collected. Venous blood samples were obtained and serological markers including hepatitis B surface antigen (HBsAg), hepatitis B surface antibody (HBsAb), hepatitis B e antigen (HBeAg), hepatitis B e antibody (HBeAb), and hepatitis B core antibody (HBcAb) were tested. Positive rates of hepatitis B virus (HBV) serological markers were analyzed by genders and ages. Results A total of 1 468 outpatients were included, among whom 721 were males (49.11%) and 747 were females (50.89%). The mean age was (46.41±19.66) years. The positive rates of HBsAg, HBsAb, HBeAg, HBeAb, and HBcAb were 7.29%, 44.75%, 1.84%, 23.50%, and 42.03%, respectively. The HBcAb positive rate in males was significantly higher than in females (46.05% vs. 38.15%, P<0.05), while no statistically significant gender differences were observed in the positive rates of other four HBV serological markers (all P>0.05). Except for HBsAb, the positive rates of the other four HBV serological markers showed statistically significant differences across different age groups (all P<0.05). Pairwise comparisons results showed that the HBsAg positive rates in age groups of 20-<40 years and 40-<60 years were 9.48% and 9.57%, respectively, which were higher than those in age groups of <20 years (1.43%) and ≥60 years (2.75%) (all P<0.05). A total of 17 HBV serological marker patterns were observed, among which the proportion of all markers negative was the highest, at 39.65%. The proportions of "small three positive" (HBsAg+, HBeAb+, HBcAb+) and "large three positive" (HBsAg+, HBeAg+, HBcAb+) patterns were 4.77% and 1.50%, respectively. Among HBsAg-positive individuals, the proportions of the "small three positive" pattern across age groups were 0, 45.45%, 90.00%, and 81.82%, while those of the "large three positive" were 0, 36.36%, 5.00%, and 0, with statistically significant differences across age groups (both P<0.05). Conclusions The positive rate of HBsAg among outpatients in medical institutions in Jiaxing City is relatively high, with a notable proportion of individuals showing either no immunity or non-response to vaccination. It is recommended to strengthen hepatitis B immunization efforts among the population aged 20-<60 years, and to enhance monitoring and interventional treatment for "small three positive" and "large three positive" patterns.
Key wordshepatitis B    hepatitis B virus serological marker    seroepidemiological
收稿日期: 2025-08-04      修回日期: 2025-10-14      出版日期: 2025-12-10
中图分类号:  R512.62  
基金资助:嘉兴市科技计划项目(2023AY11056,2023AY11008)
作者简介: 刘敏琪,硕士,医师,主要从事传染病预防与控制工作
通信作者: 戴林晔,E-mail:zjhnaids@126.com   
引用本文:   
刘敏琪, 葛锐, 侯志刚, 茅蓉, 高慧, 吴大明, 戴林晔. 嘉兴市医疗机构就诊者乙型病毒性肝炎血清流行病学调查[J]. 预防医学, 2025, 37(12): 1272-1276.
LIU Minqi, GE Rui, HOU Zhigang, MAO Rong, GAO Hui, WU Daming, DAI Linye. Seroepidemiological of hepatitis B among outpatients in medical institutions in Jiaxing City. Preventive Medicine, 2025, 37(12): 1272-1276.
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