中小学生乙型肝炎表面抗原阳性的影响因素病例对照研究

目的探讨德清县中小学生乙肝表面抗原(HBsAg)阳性的影响因素。方法根据2008年进行的德清县中小学生HBsAg检测发现的HBsAg阳性者为病例,采用1∶1匹配病例对照研究设计,以同性别、同学校、年龄上下相差不超过1岁的HBsAg阴性汉族学生为对照。通过追踪调查学生免疫接种卡获得乙肝免疫信息。结果单因素分析发现,已接种且产生乙肝表面抗体(抗-HBs)者在病例组有0人,在对照组有28人(39.44%)。长期与乙肝病例一起生活是HBsAg阳性的危险因素(P0.01)。乙肝疫苗是否接种等其他变量与HBsAg阳性间均无统计学关联。多因素分析发现,排除接种且产生抗-HBs的学生后,长期与乙肝病例一起生活是HBsAg阳性的危险因素,其OR值为15.000(95%CI为1.981～113.556)。结论乙肝疫苗接种且产生抗-HBs是乙肝病毒感染的保护因素,长期与乙肝病例一起生活是HBsAg阳性的危险因素。

Influential Factors for Hepatitis B Virus Infection in Primary and Middle School Students:A Case-control Study

Objective To study the influential factors for HBsAg positivity in primary and middle school students from Deqing County.Methods The HBsAg positive students were selected from all primary and middle schools in Deqing County who were detected in 2008.1∶ 1 pair matched case-control study was conducted.Immunization cards were traced to obtain the students’immunization information of hepatitis B virus(HBV) vaccination.Results Single factor analysis showed that there was none(0.00%) in the positive group,and there were 28 cases(39.44%) with anti-HBs positive who got hepatitis B vaccine in the control group.There was no statistical relation between HBsAg positive and other varibles such as whether having got vaccinated.Multiple factors analysis showed that Long-term living together with HBV patients was the risk factor of HBsAg positive(OR=15.000,95%CI: 1.981-113.556).Conclusion The HBV vaccination with anti-HBs positive is the protective factor of HBV infection.Long-term living together with HBV patients is the risk factor of HBsAg positive.