绵阳市农村居民HBsAg阳性、HBsAg和HBsAb双阴分布现况

目的 了解绵阳市农村居民乙肝表面抗原（HBsAg）阳性、HBsAg和乙肝表面抗体（HBsAb）双阴分布的现况，为制定农村乙肝防控策略提供科学依据。方法 采取多阶段随机抽样方法抽取163 797名农村居民作为调查对象，对其进行一对一问卷调查，并采取血标本，采用酶联免疫吸附试验（ELISA）对分离出的血清进行HBsAg和HBsAb检测，分析其表达分布的流行病学特征。结果 调查对象HBsAg总阳性率为6.57%〔95%可信区间（CI）:6.45%～6.69%〕，双阴率为40.32%（95%CI:40.36%～40.84%）。男性HBsAg阳性率（7.74%）高于女性（5.73%），双阴率（39.93%）低于女性（40.61%）；56～65岁人群HBsAg阳性率（7.36%）最高，86～96岁人群双阴率（47.61%）最高；已婚人群HBsAg阳性率（6.63%）高于未婚人群（5.54%）和离异/丧偶人群（6.11%），离异/丧偶人群的双阴率（43.04%）最高；涪城区HBsAg阳性率（9.23%）高于江油市（5.38%）和安县（5.77%），安县双阴率（55.24%）最高；有乙肝家族史人群的HBsAg阳性率（21.01%）高于无乙肝家族史人群（6.41%），双阴率（30.10%）低于后者（40.60%）；有乙肝疫苗接种史人群的HBsAg阳性率（3.78%）和双阴率（37.91%）均低于无乙肝疫苗接种史人群（分别为7.30%和40.92%）；上述差异均有统计学意义（P<0.05）。结论 绵阳市农村居民HBsAg阳性率和双阴率均较高，高龄、未接种乙肝疫苗者应重点防控。

Prevalence of HBsAg Positive and HBsAb Negative Populations in Rural Mianyang

Objective To determine the prevalence of positive HBsAg and negative HBsAg populations in rural Mianyang, and provide evidence support for proper immunization strategies. Methods A questionnaire survey was conducted on 163 797 rural residents in Mianyang selected through a multistage random sampling strategy. Serum samples were taken from the participants to detect HBsAg and HBsAb with enzyme-linked immunosorbent assay (ELISA). Results Overall, 6.57% 〔95% confidence interval (CI): 6.45%-6.69%〕 of participants were HBsAg positive. In those with negative HBsAg, 40.32% (95%CI: 40.36%-40.84%) had negative HBsAb. Higher prevalence of positive HBsAg was found in the male participants (7.74%) compared with the females (5.73%). But the male participants with negative HBsAg were less likely to have negative HBsAb (39.93%) than their female counterparts (40.61%). Those aged between 56 and 65 years had the highest prevalence of positive HBsAg (7.36%); whereas, those aged between 86 and 96 years had the highest prevalence of negative HBsAg/HBsAb (47.61%). The participants who were married (6.63%), resided in Fucheng District (9.23%), had a family history of Hepatitis B (21.01%) and were not vaccinated (7.30%) had higher prevalence of positive HBsAg than others. Those who were divorced and widowed (43.04%), resided in An County (55.24%), had no family history of Hepatitis B (40.60%), and were vaccinated (40.92%) had higher prevalence of negative HBsAg/HBsAb than others. These differences were statistically significant (P<0.05). Conclusion A high proportion of ruralresidents in Mianyang are HBsAg positive or HBsAg/HBsAb negative. The older population and those without ]vaccination should be the main target in the prevention and control of hepatitis B.