2018年浙江省健康人群乙型肝炎血清流行病学调查分析

目的了解2018年浙江省健康人群乙型肝炎（乙肝）病毒血清标志物流行情况。方法按照多阶段整群随机抽样的方法，抽取浙江省11个市及义乌市常住人口（居住6个月及以上）家庭中0～59岁人群进行问卷调查，并采集静脉血2 ml进行乙肝相关抗原抗体检测。结果共调查4 194人，乙肝表面抗原（HBsAg）和乙肝表面抗体（HBsAb）阳性率分别为4.58%（192/4 194）和63.92%（2 681/4 194）。<5岁、0～14岁、15～29岁、30～59岁人群HBsAg阳性率随年龄增加呈上升趋势（χ2=85.228，P<0.001），HBsAb阳性率呈现先下降后上升趋势（χ2=110.413，P<0.001）。 调查人群乙肝疫苗接种率为63.02%（2 643/4 194），接种率随年龄的增长呈逐渐下降趋势（χ2=2 229.121，P<0.001）。 多因素logistic分析结果显示，性别、乙肝疫苗接种史是影响成人HBsAg阳性率的主要因素，男性HBsAg阳性率高于女性（OR=1.404，95%CI:1.014～1.944），乙肝疫苗接种史者HBsAg阳性率低于无乙肝疫苗接种史者（OR=0.548，95%CI:0.371～0.810）。结论浙江省儿童乙肝防控工作取得显著成绩，但需提高成年人乙肝疫苗接种率，加强乙肝抗原抗体检测，以利于成年人乙肝防控工作。

Seroepidemiological survey of hepatitis B in healthy population in Zhejiang, 2018

ObjectiveTo investigate the serum markers of hepatitis B virus in healthy population in Zhejiang province in 2018.MethodsA questionnaire survey was conducted among 0–59 years old people with local residence >6 months who were selected through multistage stratified cluster random sampling, in 11 prefectures (municipality) and Yiwu of Zhejiang, and 2 ml of venous blood was collected from each study subjects for the detections of hepatitis B virus related antigen and antibody.ResultsA total of 4 194 people were investigated, the positive rate of HBsAg was 4.58% (192/4 194), and the anti-HBs rate was 63.92% (2 681/4 194). The positive rate of HBsAg in populations aged 0–14, 15–29 and 30–59 years increased with age ( χ2= 85.228, P<0.001). The positive rate of anti-HBs decreased first and then increased ( χ2=110.413, P<0.001). The immunization rate of hepatitis B vaccine was 63.02% (2 643/4 194). The vaccination rates decreased with age (χ2=2 229.121, P<0.001). The results of multivariate logistic analysis showed that gender and immunization history of hepatitis B vaccine were the main factors influencing the positive rate of HBsAg in adults. The positive rate of HBsAg was higher in men than in women (OR=1.404, 95%CI: 1.014–1.944). The positive rate of HBsAg was lower in patients with hepatitis B immunization history than in those without hepatitis B immunization history (OR=0.548, 95%CI: 0.371–0.810).ConclusionRemarkable achievements have been made in the prevention and control of hepatitis B in children in Zhejiang. It is beneficial for the prevention and control of hepatitis B in adults by increasing the immunization rate of hepatitis B vaccine and strengthening the detections of hepatitis B virus antigen and antibody in this population.