CAJ | 학술논문

目的建立北京市病毒性乙型肝炎表面抗原携带率的流行病学数学模型,并比较不同接种策略对乙肝表面抗原携带率的控制效果.方法利用既往的乙肝血清学调查数据和传染病数学建模思想,由实际资料和文献资料确定传染力等参数,建立由偏微分方程表达的病毒性乙型肝炎表面抗原携带率流行动力学仓室模型.结果建立了包括易感者、潜隐者、临时带毒者、持续带毒者和免疫者五个仓室的病毒性乙型肝炎表面抗原携带率动力学数学模型,模型模拟的结果与实际观察值相符,模型能够反映病毒性乙型肝炎在人群中的传播过程.利用该模型进行预测后发现,在现有接种策略下,大约在10年后全市的乙肝病毒表面抗原携带率降为2％以下；如果改变接种策略,在成人19-50岁年龄组人口进行乙肝疫苗强化接种,可以提前2年将乙肝病毒携带率降到2％以下.结论建立的数学模型能够对现有接种策略下的乙型肝炎的发展趋势给出较为准确和清晰的认识,同时可以对不同接种策略下全人群的HBsAg携带率变化情况进行动态的描述.对成人实施强化免疫策略仅比现行策略提前两年实现区域全人群HBsAg携带率降到2％以下防治目标.
목적 건립북경시병독성을형간염표면항원휴대솔적류행병학수학모형,병비교불동접충책략대을간표면항원휴대솔적공제효과.방법 이용기왕적을간혈청학조사수거화전염병수학건모사상,유실제자료화문헌자료학정전염력등삼수,건립유편미분방정표체적병독성을형간염표면항원휴대솔류행동역학창실모형.결과 건립료포괄역감자、잠은자、림시대독자、지속대독자화면역자오개창실적병독성을형간염표면항원휴대솔동역학수학모형,모형모의적결과여실제관찰치상부,모형능구반영병독성을형간염재인군중적전파과정.이용해모형진행예측후발현,재현유접충책략하,대약재10년후전시적을간병독표면항원휴대솔강위2％이하；여과개변접충책략,재성인19-50세년령조인구진행을간역묘강화접충,가이제전2년장을간병독휴대솔강도2％이하.결론 건립적수학모형능구대현유접충책략하적을형간염적발전추세급출교위준학화청석적인식,동시가이대불동접충책략하전인군적HBsAg휴대솔변화정황진행동태적묘술.대성인실시강화면역책략부비현행책략제전량년실현구역전인군HBsAg휴대솔강도2％이하방치목표.
Objective To establish the epidemiological mathematical model and contrast different vaccination strategy' effects on HBsAg carrier rate in Beijing.Methods Using previous Hepatitis B serological investigation data and the ideology of infectious disease mathematical model (SIR),establish the dynamic compartment model of HBsAg carrier rate expressed by partial differential equations whose parameters are from the actual data and the references.Results Established the dynamic compartment model with five compartments include susceptible and latent period and transient viremia and chronic carriage as well as immune.The results from the simulation of the model match well with the actual data.It reflects the process of hepatitis B virus transmission.From the model,we predict that under the existing vaccination strategy,HBsAg carrier rate will decrease below 2％ after 10 years and if the immunity vaccination strategy is changed to strengthen vaccination between 15 to 50 age,HBsAg carrier rate will decrease below 2％ after 8 - 10 years,2 years in advance.Conclusion The established mathematical model can give a accurate and clear knowledge of the trend for hepatitis B Virus under the existing immunity vaccination strategy.At the same time,it can give the dynamics description of HBsAg carrier rate of each age groups under different immunity vaccination strategy.Based on the prediction of the model,to attain the object of controlling the HBsAg carrier rate below 2％,administering adult strengthen immunity strategy will take only 2 years fewer than applying the existing policy.