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河南省18岁及以下住院患者HBV血清流行病学特征分析
DOI: 10.3969/j.issn.1001-5256.2023.05.009
伦理学声明：本研究方案于2021年12月24日经由河南省人民医院伦理委员会审批，批号：184号。
利益冲突声明：本文不存在任何利益冲突。
作者贡献声明：李威负责课题设计，资料分析，撰写论文；康艳红、张江峰、殷辉、刘俊平参与收集数据，修改论文；康谊、李玉魁负责指导撰写文章并最后定稿。
Seroepidemiological characteristics of hepatitis B virus among hospitalized patients aged 18 years or below in Henan Province of China
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摘要:
目的 调查1~18岁住院患者HBV感染现状，分析乙型肝炎疫苗接种后免疫情况。 方法 收集2020年7月—2021年7月1~18岁河南省人民医院住院患者的乙型肝炎血清学标志物(HBsAg、抗-HBs、HBeAg、抗-HBe和抗-HBc)以及乙型肝炎疫苗接种等信息，分析HBV感染流行现状和疫苗接种后的免疫效果。趋势分析采用趋势χ2检验。 结果 共收集住院患者10 658例，男6 372例(59.79%)，女4 286例(40.21%)。人群整体HBsAg阳性占比为0.28%(30/10 658)，17、18岁年龄组HBsAg阳性占比较高，分别为0.68%和0.62%；抗-HBs阳性占比为51.82%(5 523/10 658)，其中1~4岁年龄组抗-HBs阳性占比处于较高水平，均在63%以上，5~18岁年龄组抗-HBs阳性占比下降，波动在40%左右。随着年龄增长，无论男性还是女性，抗-HBs阳性均有下降趋势(男性：χ2=8.217, P=0.004，女性：χ2=10.048, P=0.002)。 结论 基于住院患者数据，河南省1~18岁人群HBV感染呈现低水平流行、高免疫特点，本地区计划免疫5年以上抗-HBs阳性占比下降的现象需要关注。 Abstract:Objective To investigate the current status of hepatitis B virus (HBV) infection among hospitalized patients aged 1-18 years, as well as the status of immunity after hepatitis B vaccination. Methods Related data were collected from the patients aged 1-18 years who were hospitalized in Henan Provincial People's Hospital from July 2020 to July 2021, including serological markers for hepatitis B (HBsAg, anti-HBs, HBeAg, anti-HBe, and anti-HBc) and hepatitis B vaccination. The epidemiological situation of HBV infection was analyzed, as well as the immune effect after vaccination. The trend chi-square test was used for trend analysis. Results A total of 10 658 hospitalized patients were collected, among whom there were 6 372 male patients (59.79%) and 4 286 female patients (40.21%). In this population, the patients with positive HBsAg accounted for 0.28% (30/10 658), with a relatively high proportion of 0.68% and 0.62%, respectively, in the 17-and 18-year age groups; the patients with positive anti-HBs accounted for 51.82% (5 523/10 658), with a relatively high proportion of > 63% in the 1-4 years age groups, and there was a reduction in the proportion of patients with positive anti-HBs (fluctuating around 40%) in the 5-18 years age groups. With the increase in age, the positive rate of anti-HBs tended to decrease in both male and female patients (male: χ2=8.217, P=0.004; female: χ2=10.048, P=0.002). Conclusion Based on the data of hospitalized patients, HBV infection in the population aged 1-18 years in Henan Province has the characteristics of low prevalence rate and high immunity, and the reduction in the proportion of patients with positive anti-HBs at more than five years after vaccination should be taken seriously in this region. -
Key words:
- Hepatitis B Virus /
- Biomarkers /
- Child
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表 1 1~18岁10 658例人群HBV血清学标志物特点
Table 1. Characteristics of HBV serological markers in 10 658 people aged 1-18 years
HBsAg 抗-HBs HBeAg 抗-HBe 抗-HBc 人数
(例)构成比(%) - + - - - 5 523 51.82 - - - - - 5 071 47.58 + - + - + 24 0.23 - + - - + 23 0.22 - - - - + 6 0.06 - + - + + 4 0.04 + - - + + 4 0.04 + + - - - 1 0.01 + - + - - 1 0.01 - - - + + 1 0.01 注：-表示阴性，+表示阳性。 
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表 2 不同年龄组HBsAg阳性分布
Table 2. The distribution of HBsAg prevalence in different age groups
年龄 总数
(例)HBsAg阳性
[例(%)]HBeAg
阳性(例)抗-HBe
阳性(例)抗-HBc
阳性(例)1岁 584 2(0.34) 2 0 3 2岁 547 1(0.18) 1 0 2 3岁 626 1(0.16) 0 1 4 4岁 640 2(0.31) 3 0 6 5岁 602 1(0.17) 1 0 2 6岁 605 2(0.33) 0 2 3 7岁 544 1(0.18) 1 0 3 8岁 527 2(0.38) 2 0 3 9岁 542 1(0.18) 0 0 0 10岁 564 1(0.17) 2 1 3 11岁 570 1(0.18) 0 0 3 12岁 595 2(0.34) 2 0 3 13岁 629 1(0.16) 1 0 4 14岁 586 1(0.17) 1 0 3 15岁 656 1(0.15) 1 1 2 16岁 607 2(0.33) 2 0 2 17岁 586 4(0.68) 4 2 10 18岁 648 4(0.62) 3 2 6 合计 10 658 30(0.28) 26 9 62
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表 3 1~18岁人群血清抗-HBs阳性分布
Table 3. The distribution of HBsAb prevalence in population aged 1-18
年龄 总数
(男/女，例)总抗-HBs阳性 男性抗-HBs阳性 女性抗-HBs阳性 例数 百分比(%) 例数 百分比(%) 例数 百分比(%) 1岁 584(335/249) 551 94.35 320 95.52 231 92.77 2岁 547(316/231) 466 85.19 272 86.08 194 83.98 3岁 626(361/265) 465 74.28 273 75.62 192 72.45 4岁 640(364/276) 407 63.59 232 63.74 175 63.41 5岁 602(350/252) 295 49.00 172 49.14 123 48.81 6岁 605(342/263) 270 44.63 144 42.11 126 47.91 7岁 544(332/212) 281 51.65 165 49.70 116 54.72 8岁 527(336/191) 216 40.99 138 41.07 78 40.84 9岁 542(359/183) 242 44.65 159 44.29 83 45.36 10岁 564(341/223) 250 44.33 158 46.33 92 41.26 11岁 570(357/213) 249 43.68 154 43.14 95 44.60 12岁 595(344/251) 239 40.17 143 41.57 96 38.25 13岁 629(379/250) 245 38.95 143 37.73 102 40.80 14岁 586(346/240) 226 38.57 136 39.31 90 37.50 15岁 656(372/284) 269 41.01 162 43.55 107 37.68 16岁 607(374/233) 256 42.17 163 43.58 93 39.91 17岁 586(382/204) 272 46.42 177 46.34 95 46.57 18岁 648(382/266) 324 50.00 200 52.36 124 46.62 合计 10 658 (6 372/4 286) 5 523 51.82 3 311 51.96 2 212 51.61
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