2009年广东省部分地区1～14岁儿童乙型肝炎病毒感染状况分析

目的了解广东省部分地区1-14岁儿童乙型肝炎病毒感染现状，为制定乙肝高流行区防制策略提供科学理论依据。方法2009年在广东省韶关南雄市、汕尾海丰县和云浮新兴县采取分层多阶段随机抽样方法，抽取1～14岁儿童作调查对象，调查内容包括调查对象的基本情况、患病史以及乙肝疫苗接种史等，并采用雅培试剂化学发光法检测调查对象的HBsAg、抗-HBs、抗-HBc。结果共调查1185人，其中男性684人，女性501人；本地户籍占99．75％（1182／1185）。HBV感染率为11．22％（133／1185），HBsAg阳性率为2．53％（30／1185），抗-HBs阳性率为55．70％（660／1185），抗-HBc阳性率为7．85％（93／1185）。1～14岁儿童各年龄组之间HBV感染率、HB-sAg、抗-HBs、抗-HBc阳性率的差异均有统计学意义（P〈0．05或P〈0．01）。南雄市HBsAg、抗-HBs阳性率（4．51％、67．17％）高于海丰县和新兴县，差异有统计学意义（均P〈0．01）。调查的1～14岁人群中，乙肝疫苗接种率为87．34％（1035／1185）；在具有完整接种记录的890人中，全程接种率、首针及时接种率分别为90．90％（809／890）、78．31％（697／890），1～6、7～9和10～14岁组相比较，随着年龄的增长，乙肝疫苗全程接种率以及首针及时接种率逐渐降低，而HBsAg阳性率则逐渐升高（P〈0．05或P〈0．01）。结论广东省调查地区1～14岁儿童乙型肝炎病毒感染水平高于全国平均水平，因此，应继续保持新生儿高水平的乙肝疫苗全程接种率并进一步提高首针及时接种率，加强儿童入托入学查验预防接种证工作并及时查漏补种，从而进一步降低乙型肝炎病毒的感染水平。

Seroepidemiological status of hepatitis B virus in children aged 1 - 14 years in certain regions of Guangdong Province, 2009

Objective To understand the seroepidemiological status of hepatitis B virus （HBV） in children aged 1 - 14 years in certain regions of Guangdong Province and provide the scientific and academic basis for making strategies to control HBV infection in highly epidemic area. Methods A muhi-stage stratified random sampling was designed to survey children aged 1 - 14 years in Nanxiong, Haifeng, and Xinxing counties in 2009. The contents of the questionnaire included general information, medical histoly, and hepatitis B vaccine. The serum samples were tested with chemiluminescence method for HBsAg, anti- HBs, and anti-HBc. Results A total of 1 185 children were investigated, including 684 males and 501 females. Of them, the infection rate of HBV and the positive rates of HBsAg, anti-HBs, and anti-HBc were 11.22% （133/1 185）,2.53% （30/1 185）,55.70% （660/1 185）, andT. 85% （93/1 185）, respec- tively. There were significant differences in the infection rate of HBV and positive rates of HBsAg, anti- HBs, anti-HBc between different age groups （P 〈 0.05 or P 〈 0.01 ）. The immunization coverage rate of hepatitis B vaccine was 87.34%. Among 890 children with complete vaccination records, three-dose hepa- titis B vaccine immunization coverage rate and timely birth dose coverage rate were 90.90% （ 809/890 ） and78.31% （697/890）, respectively. Comparing 1 -6 age group with 7 -9 age group and 10 - 14 age group, three-dose hepatitis B vaccine immunization coverage rate and timely birth dose coverage rate were reducing along with the rising of age, while the positive rate of HBsAg was rising （P 〈0.05 or P 〈0.01 ）. Conclusion The seroepidemiologieal level of hepatitis B in investigated areas of Guangdong Province is higher than the average level in China. To control the HBV infection in children aged 1 - 14 in investigated areas, we should keep high three-dose hepatitis B vaccine coverage rate in the neonates and improve the timely birth dose coverage rate of hepatitis B vaccine. Meanwhile, it is also important to improve and enhance vaccination certificate inspection and replant hepatitis B vaccine.