摘要
目的 了解云南省住院分娩孕产妇HBV感染状况.方法 对云南省16个州市129个县范围内2011年l-6月孕产妇进行HBV血清学5项指标筛查,阳性者采集静脉血3 mL进行HBV DNA定量检测,同时进行问卷调查采集孕产妇年龄、居住地及文化程度等信息,比较不同年龄组、居住地、文化程度及感染模式孕产妇HBV DNA水平的差异.结果 调查共筛查235 032人,HBV感染率为2.28％(5 364例),获得合格血液样本4 308份,样本采集率为80.31％;15～34岁占91.71％(3 951人),农村居民占80.52％(3 469人),高中(中专)及以下学历占93.03％(4 008人).4 308份血液样本共检测出18种感染模式,其中模式1(HBsAg、HBeAg、抗-HBc项阳性)和模式2(HBsAg、抗-HBe、抗-HBc项阳性)分别占38.74％(1 669例)和45.57％(1 963例);模式4(HBsAg、抗-HBc项阳性)和模式9(HBsAg、HBeAg项阳性)分别占10.17％(438例)和2.16％(93例).不同年龄组孕产妇HBV感染模式1、模式2、模式4和模式9构成比的差异均有统计学意义(χ2=240.76,P＜0.01;X2=203.27,P＜0.01;χ2-=12.40,P＜0.01;x2=10.18,P＜0.05).15～24岁组以模式1感染为主,占52.19％(918/1 759);25～34岁组35～51岁组均以模式2感染为主,分别占52.24％(1 145/2 192)和64.43％(230/357).农村孕产妇模式1感染率为40.53％(1 406/3 469),高于城镇组;模式2感染率为44.31％(1 537/3 469),低于城镇组(x2=21.38和14.17,P均＜0.01).高中(中专)及以下学历模式1的感染率为39.65％(1 589/4 008),高于大专及以上组(X2=21.81,P＜0.01);模式2和模式4感染率分别为44.74％(1 793/4008)和10.03％(402/4008),均低于大专及以上学历组(X2=16.08,P＜0.01;x2=6.46,P＜0.05).模式1和9感染孕产妇中,HBVDNA＞105 IU/mL者占比较高,分别达到84.84％(1 416/1 669)和89.25％(83/93);模式2和模式4感染的孕产妇HBV DNA＜500 IU/mL者占比高,分别达到81.25％(1 595/1 963)和76.48％(335/438).结论 云南省现阶段孕产妇感染HBV血清学组合模式以模式1、模式2为主,HBV DNA含量以＜500 IU/mL及＞105 IU/mL为主,年龄集中在15～34岁,以农村居民及低文化程度群体为主.
Abstract
Objective To study the prevalence on HBV of the hosptalized pregnant women in Yunnan province.Methods From January to June,2011,the pregnant women from 16 prefectures and 129 counties were screened by five HBV serological markers (HBsAg,anti-HBs,HBeAg,anti-HBe and anti-HBc).After investigation,3 mL serum samples were collected for quantity detection of HBV DNA.Meanwhile,the information of age,place of residence and education status were collected by questionnaire to compare the differences of HBV DNA quantity.Results A total of 235 032 people were investigated.Among them,the infection rate of HBV was 2.28％ (5 364 cases).There were 4 308 qualified blood samples in the study with harvedting the rate of 80.31％,of which 3 951 cases (91.71％) were between 15-34 years old,3 469 cases (80.52％) were rural residences,and 4 008 cases(93.03％) were high school graduates or even with lower education level.There were 18 combinations of HBV markers in the 4 308 blood samples.Four profiles of infections were major proportions:the 1st profile (HBsAg,HBeAg and anti-HBc positive)and the 2nd profile (HBsAg,anti-HBe and anti-HBc positive),the 4th profiles (HBsAg and anti-HBc positive) and the 9th profiles (HBsAg and HBeAg positive) which were respectively accounted for 38.74％ (1 669 samples) and 45.57％ (1 963 samples),10.17％ (438 samples) and 2.16％ (93 samples).The differences of composition ratio between pregnant women's HBV infection profile 1,2,4 and 9 in various age groups have statistical significance (x2=240.76,P＜0.01;χ2=203.27,P＜0.01;X2=12.40,P＜0.01;X2=10.18,P＜0.05).The patients in the age group of 15 to 24 years old were infected by profile 1 and accounted for 52.19％ (918/1 759); while the patients in the age groups of 25 to 34 years old and the 35 to 51 years old were infected mainly by profile 2,respectively accounted for 52.24％(1 145/2 192) and 64.43％(230/357).The infection ratio of profile 1st for rural pregnant women was 40.53％(1 406/3 469),which was higher than urban group; and profile 2 accounted for 44.31％ (1 537/3 469),which was lower than urban group (X2=21.38 and 14.17,P both＜0.01).The infection ratio of profile 1 for high school graduates or even with lower education level was 39.65％(1 589/4 008),which was higher than college education ones (x2=21.81,P＜ 0.01); while their infection ratio of profile 2 and 4 were respectively 44.74％ (1 793/4 008) and 10.03％ (402/4 008),which were lower than college education ones (X2=16.08,P＜0.01; X2=6.46,P＜0.05).Among the infected pregnant women of profile 1 and 9,of whom the HBV DNA＞105 IU/mL took more percentage,which were respectively 84.84％ (1 416/1 669) and 89.25％ (83/93); while in profile 2 and 4,HBV DNA＜500 IU/mL took more percentage,which were respectively 81.25％ (1 595/1 963) and 76.48％(335/438).Conclusions The profile 1 and 2 are the main combinations among the HBV infection pregnant women in Yunnan province.The quantity of HBV DNA is mainly less than 500 IU/mL and more than 105 IU/mL.The mainly age group is 15 to 34 year old.The major subjects are low-level education ones and rural area ones.
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维普
万方数据