小学生乙型肝炎表面抗原阳性的影响因素病例对照研究

目的探讨麻阳县小学生乙肝表面抗原(HBsAg)阳性的影响因素,为进一步控制乙肝的流行提供科学依据。方法根据2007年用分层随机整群抽样进行的麻阳县小学生HBsAg携带状况现况调查结果,采用1∶2匹配病例对照研究设计,以HBsAg阳性的小学生为病例,同性别、同自然村或街道和年龄上下相差不超过2岁的HBsAg阴性的小学生为对照。使用统一的调查表进行问卷调查。调查资料的数据用SPSS 11.0软件包进行条件logistic单因素和多因素回归分析。结果单因素条件logistic回归分析显示母亲文化程度、家庭人均年收入、肌注或点滴、拔牙、打预防针、一次性注射器具、一人一针一管、乙肝疫苗接种、乙肝疫苗首针及时接种、乙肝疫苗全程接种、乙肝疫苗加强接种、母亲患乙肝或HBV携带者等因素与小学生HBsAg阳性率差异有统计学意义(P0.05),将上述12个因素作多因素条件logistic逐步回归分析,最后有6个因素:肌注或点滴、拔牙、母亲患乙肝或HBV携带者、母亲文化程度、乙肝疫苗首针及时接种、一次性注射器具与小学生HBsAg阳性率差异有统计学意义(P0.05)。结论肌注或点滴、拔牙和母亲患乙肝或HBV携带者是小学生HBsAg阳性的危险因素。母亲文化程度、家庭人均年收入、打预防针、一次性注射器具、乙肝疫苗接种、乙肝疫苗首针及时接种、乙肝疫苗全程接种和乙肝疫苗加强接种是小学生HBsAg阳性的保护因素,而其中的母亲文化程度、乙肝疫苗首针及时接种和一次性注射器具是主要的保护因素。

A Case-control study of risk factors on HBsAg positivity among children in primary school

Objective To study the risk factors for HBV infection among primary school students and to provide epidemiological evidences for HBV control in Mayang county,Hunan province.Methods In 2007,a case-control study was designed and completed with 1∶2 ratio by stratified random cluster sampling adjusting by gender,village and age（less than 2 years difference）.A conditional logistic regression model was used for single variable and multiple variables with SPSS11.0.Results The HBV positivity was respectively associated with 12 variables,which included mother′s educational level,the average income of family,history of intramuscular injection or intravenous infusion,history of tooth removal in hospital,vaccination history,application of disposable syringe,no sharing with syringe,history of HBV vaccination,HBV vaccination in 24 hours,completeness of HBV vaccination,booster shot for HBV vaccine and mother′s HBV infection status（P0.05）.Logistic regression model suggested that HBV positivity was associated with history of intramuscular injection or intravenous infusion,history of tooth removal in hospital,application of disposable syringe,HBV vaccination in 24 hours,mother′s educational level as well as mother′s HBV infection status（P0.05）.Conclusion The results suggested the existence of family related and medical practice related HBV infection risks in Mayang county.