CAJ | 학술논문

目的探讨北京市朝阳区乙型肝炎病毒( HBV)感染的家庭聚集性及其传播危险因素.方法于2010年在北京市朝阳区采用多阶段整群抽样的方法,随机抽取5266个家庭进行调查.以调查家庭中年龄大于1岁、小于70岁,并在北京连续居住半年以上的成员作为调查对象,包括户口不在本地的暂住人口(不包括外国公民),共14 491名,每名成员采集5 ml静脉血.采用自行设计的问卷调查研究对象人口学基本特征及乙型肝炎(简称乙肝)传播危险因素.采用微粒子酶免疫测定方法,检测研究对象乙肝五项指标.对有乙肝表面抗原( HBsAg)阳性者的家庭进行负二项分布拟合检验,并计算乙肝家庭聚集率,以单因素分析和多因素logistic回归模型分析HBV传播危险因素.结果 5266个家庭中,有HBsAg阳性成员的家庭有308个,占总家庭数的5.85％.调查对象HBsAg阳性率为2.66％ (383/14 410),14岁以下调查对象HBsAg 阳性率最低为0.56％ (9/1603),35 ～ 44岁调查对象HBsAg阳性率最高为4.27％ (47/1029).负二项分布拟合检验发现,HBV感染家庭聚集率为7.66％(X2 =15.10,P＜0.05).对HBsAg 阳性聚集家庭传播关系分析显示:HBV父传子所占比例为17.39％ (8/46);母传子所占比例为13.04％ (6/46);夫妻间传播所占比例为30.44％ (14/46);兄弟姐妹或其他亲属间传播所占比例为39.13％(18/46).对HBsAg阳性聚集家庭传播关系的单因素分析和多因素logistic回归模型分析均发现:家庭有乙肝患者(OR=5.40,95％ CI:5.24 ～ 5.55)、朋友或同事有乙肝患者( OR=1.55,95％CI:1.11 ～1.99)和有受献血史(OR=1.96,95％ CI:1.76 ～2.15)为HBV传播的危险因素.结论 HBV感染者在家庭内传播具有家庭聚集性,HBV传播的危险因素结论有待进一步研究.
목적 탐토북경시조양구을형간염병독( HBV)감염적가정취집성급기전파위험인소.방법 우2010년재북경시조양구채용다계단정군추양적방법,수궤추취5266개가정진행조사.이조사가정중년령대우1세、소우70세,병재북경련속거주반년이상적성원작위조사대상,포괄호구불재본지적잠주인구(불포괄외국공민),공14 491명,매명성원채집5 ml정맥혈.채용자행설계적문권조사연구대상인구학기본특정급을형간염(간칭을간)전파위험인소.채용미입자매면역측정방법,검측연구대상을간오항지표.대유을간표면항원( HBsAg)양성자적가정진행부이항분포의합검험,병계산을간가정취집솔,이단인소분석화다인소logistic회귀모형분석HBV전파위험인소.결과 5266개가정중,유HBsAg양성성원적가정유308개,점총가정수적5.85％.조사대상HBsAg양성솔위2.66％ (383/14 410),14세이하조사대상HBsAg 양성솔최저위0.56％ (9/1603),35 ～ 44세조사대상HBsAg양성솔최고위4.27％ (47/1029).부이항분포의합검험발현,HBV감염가정취집솔위7.66％(X2 =15.10,P＜0.05).대HBsAg 양성취집가정전파관계분석현시:HBV부전자소점비례위17.39％ (8/46);모전자소점비례위13.04％ (6/46);부처간전파소점비례위30.44％ (14/46);형제저매혹기타친속간전파소점비례위39.13％(18/46).대HBsAg양성취집가정전파관계적단인소분석화다인소logistic회귀모형분석균발현:가정유을간환자(OR=5.40,95％ CI:5.24 ～ 5.55)、붕우혹동사유을간환자( OR=1.55,95％CI:1.11 ～1.99)화유수헌혈사(OR=1.96,95％ CI:1.76 ～2.15)위HBV전파적위험인소.결론 HBV감염자재가정내전파구유가정취집성,HBV전파적위험인소결론유대진일보연구.
Objective To explore the family aggregation and risk factors of hepatitis B virus (HBV) transmission in Chaoyang district of Beijing.Methods A total of 5266 families were randomly selected for the multi-stage cluster sampling study in Chaoyang district of Beijing in 2010.The family members who aged between 1 and 70 years old and lived constantly in Beijing for over half a year,were recruited as subjects.There were 14 491 subjects in total,including temporary residents who did not have Beijing household account,except foreigners.5 ml venous blood was drawn from every subject.A self-designed questionnaire was used to collect the basic information of the population and the risk factors of the hepatitis B transmission.Microparticle enzyme-linked immunoassay was applied to test five indicators of hepatitis B.Negative binomial distribution test was used among the HBsAg positive families to calculate the family aggregation rate of hepatitis B.Single factor analysis and multi-factor logistic regression model were used to analyze the risk factors of HBV transmission.Results In all,308 out of 5266 families had HBsAg positive members,accounting for 5.85％.383 out of 14 410 subjects were HBsAg positive,rating at 2.66％.The HBsAg positive rate among subjects under 14 years old was the lowest,at 0.56％ (9/1603) ;and the positive rate among subjects aging between 35 and 44 years old was the highest,at 4.27％(47/1029).Negative binomial distribution test showed that the family aggregation rate of HBV infection was 7.66％ ( X2 =15.10,P ＜0.05 ).The analysis of family aggregation of HBsAg positive showed that 17.39％(8/46) of the transmission was from father to child,13.04％ (6/46) was from mother to child,30.44％(14/46) was between couples,and another 39.13％ (18/46) was between siblings or other relatives.Both single factor analysis and multi-factor logistic regression analysis showed that hepatitis B positive family members ( OR =5.40,95％ CI:5.24-5.55 ),hepatitis B positive friends and colleagues ( OR =1.55,95％ CI:1.11-1.99 ) and blood do(n)ation and transfusion history ( OR =1.96,95％ CI:1.76-2.15 ) were the risk Factors of HBV infection.Conclusion HBV transmission showed family aggregation in Beijing,however,the risk factors needed further studies.