马鞍山市16年乙型肝炎防治效果评价

目的了解马鞍山市乙型肝炎（下称乙肝）流行状况，评价防治效果，为制定或调整乙肝疫苗接种策略提供依据。方法按照两阶段抽样法，抽取8个行政村1～59岁常住人口2040人，采静脉血3—5ml，ELISA法检测HBV—M。结果HBsAg阳性70人，阳性率3．43％；HBV—M总感染率18．40％，HBsAg阳性率较1991年（13．41％）显著降低（χ^2=116．95，P=0．000）。1992年推广乙肝疫苗接种以来，其保护率达73．08％。2007年与1991年健康人群乙肝血清学各项指标分地区、城乡、性别、年龄比较，除HBsAb20岁以上年龄组外，差异均有统计学意义；职业分布发生变化，1991年学生HBsAg阳性构成比占59．32％，农民占12．43％；2007年学生HBsAg阳性构成比下降到11．27％，农民构成比上升到50．70％。结论该市乙肝防治效果非常显著，继续开展新生儿乙肝免费接种，推广成人接种，并将预防乙肝资源向农村地区倾斜.

Evaluation of the Effect of Hepatitis B Prevention and Control for 16 years in Maanshan

Objective] To understand the epidemic situation of Hepatitis B in Maanshan, evaluate the effect of the control measures, provide evidence for the establishment and adjustment of hepatitis B vaccination strategy. Methods] Two-stage sampling method was designed to collect 2 040 residents aged between 1 to 59 in 8 villages ; 3 - 5 ml blood samples were taken, HBV-M was detected with ELISA. Results] 70 HBsAg positive individuals were detected, the positive rate was 3.43% ; the total HBV-M infection rate was 18.40%, the HBsAg positive rate significantly decreased compared with that in 1991 （ 13.41% ） ; χ^2 = 116.95, P = 0. 000 ） ; the protection efficiency reached 73.08% since the promotion of hepatitis B vaccination in 1992 ; significant difference was found between the year of 2007 and 1991 in the serologic indicators of hepatitis B according to regions, areas （ urban and rural） , gender and age with the exception of HBsAb in group aged above 20; in 1991, the proportion of HBsAg positive students and farmers were 59.32% and 12.43% respectively, while in 2007, the proportion were 11.27% and 50.70% respectively. Conclusion] The effect of Hepatitis B prevention is significantly obvious in this city ; the free of charge neonatal hepatitis B vaccination should be continued and more resources of hepatitis B prevention should be provided for the rural areas.