贵州少数民族人群乙肝流行率及流行模式分析

摘要:目的　了解贵州少数民族人群乙肝流行率及流行模式，为制定乙肝防治策略提供依据。方法　采用多阶段整群随机抽样方法，于2013年11-12月抽取贵州省3个少数民族自治州中的2个县8个村共1629名常住居民，进行问卷调查同时采集血样，用时间分辨免疫荧光法（TRFIA）检测血清中乙肝表面抗原（HBsAg）、乙肝表面抗体（HBsAb）、乙肝核心抗体（HBcAb），分析乙肝流行模式。结果　1629名调查对象中，HBV 感染者825例，总感染率为 50.6%；共有 6种血清标志物模式组合，按照血清标志物模式分布特征将乙肝流行模式分为三类，其中以易感模式为主占45.9%、免疫模式占31.9%、感染模式占22.2%；不同民族、一起生活的人有无表面抗原阳性、不同婚姻状态、不同年龄、家庭HBV感染人数、是否接种乙肝疫苗、家庭人口数、是否饮酒、文化程度在3组流行模式间差异均有统计学意义（P＜0.05）；是否外出打工过、性别、是否共用牙刷、过去1年家庭总收入不同、是否吸烟在3组流行模式间差异均无统计学意义（P＞0.05）。结论　贵州少数民族人群乙肝流行模式以易感模式（3项全阴）为主，不同特征人群流行模式存在差异；易感模式流行的人群应加强免疫接种，提高该人群的乙肝特异性免疫力；对感染模式流行人群加强健康宣教，减少其乙肝的传播。

Prevalence pattern of hepatitis B among minority population in Guizhou Province

Abstract: Objective To explore the prevalence pattern of hepatitis B among minority population in Guizhou so as to provide evidence for the strategies on hepatitis B prevention and control. Methods With multi-stage cluster random sampling method, 1629 permanent residents were recruited from eight villages in two counties among three minority autonomous prefectures in Guizhou Province. They were surveyed by questionnaires and their blood samples were collected. Hepatitis B virus surface antigen (HBsAg), hepatitis B virus surface antibody (HBsAb) and hepatitis B virus core antibody (HBcAb) were detected with time-resolved fluorescence immunoassay (TRFIA) method. Results Among 1629 subjects, a total of 825 persons were infected by HBV, with the overall infection rate as 50.6%. Six kinds of serological markers model were observed. According to the characteristic of serological markers model distribution, prevalence model of hepatitis B was divided into three categories, susceptible model in the top and immune model and infection model with the proportion of 45.9%, 31.9% and 22.2%, respectively. There were significant differences between the three groups of prevalence model in different nation, family members of positive HBV surface antigen (HBsAg), marital status, age, family population with HBV infection, vaccination history of hepatitis B, family population, drink and education level (P<0.05); while the differences of migrant work, sex, sharing toothbrush, total family income of last year and smoke were no significant difference (P>0.05). Conclusion Susceptible model was the major prevalence model of hepatitis B among minority population, in Guizhou Province. There were differences in prevalence model of population in different characteristic. In order to improve the specific immunity, the population of susceptible model should strengthen hepatitis B vaccination. The population of infection model should strengthen health education to reduce the transmission of hepatitis B.