CAJ | 학술논문

目的分析渝东南片区家族性乙型病毒性肝炎发病情况，为减少或阻断家族性乙型肝炎的传播，防治家族聚集性乙型肝炎提供对策。方法选择110例家族性乙型肝炎患者，总计其家族成员共有295例HbsAg阳性成员，按男性及女性、已婚及未婚进行分组，调查家族直系三代乙型肝炎病毒感染情况，区分母婴之间、父婴之间的传播，分析乙型肝炎疫苗接种情况，分析家族中肝硬化、肝癌的发病情况，死亡病例调查死亡原因，统计男女发病的差异性。结果110例乙型肝炎患者配偶感染的概率男性为22．2％，女性为20．5％，二者差异无统计学意义（ P＞0．05）。而母辈阳性的其子女感染率达到（66．7％以上），明显高于父辈阳性的子女感染率（≤11．1％），二者差异有统计学意义（ P＜0．05）。该区成年家族聚集性乙型肝炎患者普遍乙型肝炎疫苗接种率较低（≤23．2％），乙型肝炎免疫球蛋白的使用就更低（2．7％）。295例 HbsAg阳性成员肝硬化的发病率为8．5％，原发性肝癌（HCC）发病率为4．4％，因肝病死亡19例（16个家庭），110例乙型肝炎患者39例（35．4％）进行规范化乙型肝炎抗病毒治疗。结论母婴传播是家族聚集性乙型肝炎感染的主要原因，父婴传播、密切的生活接触仍可以导致乙型肝炎感染，该区家族聚集性乙型肝炎感染高发病与乙型肝炎疫苗的接种率、乙型肝炎免疫球蛋白的使用率低有关。未规范化乙型肝炎抗病毒治疗，是导致家族聚集性乙型肝炎并发肝硬化或HCC高发的主要原因。
목적분석투동남편구가족성을형병독성간염발병정황，위감소혹조단가족성을형간염적전파，방치가족취집성을형간염제공대책。방법선택110례가족성을형간염환자，총계기가족성원공유295례HbsAg양성성원，안남성급녀성、이혼급미혼진행분조，조사가족직계삼대을형간염병독감염정황，구분모영지간、부영지간적전파，분석을형간염역묘접충정황，분석가족중간경화、간암적발병정황，사망병례조사사망원인，통계남녀발병적차이성。결과110례을형간염환자배우감염적개솔남성위22．2％，녀성위20．5％，이자차이무통계학의의（ P＞0．05）。이모배양성적기자녀감염솔체도（66．7％이상），명현고우부배양성적자녀감염솔（≤11．1％），이자차이유통계학의의（ P＜0．05）。해구성년가족취집성을형간염환자보편을형간염역묘접충솔교저（≤23．2％），을형간염면역구단백적사용취경저（2．7％）。295례 HbsAg양성성원간경화적발병솔위8．5％，원발성간암（HCC）발병솔위4．4％，인간병사망19례（16개가정），110례을형간염환자39례（35．4％）진행규범화을형간염항병독치료。결론모영전파시가족취집성을형간염감염적주요원인，부영전파、밀절적생활접촉잉가이도치을형간염감염，해구가족취집성을형간염감염고발병여을형간염역묘적접충솔、을형간염면역구단백적사용솔저유관。미규범화을형간염항병독치료，시도치가족취집성을형간염병발간경화혹HCC고발적주요원인。
Objective To investigate the incidence of familial hepatitis B viral (HBV ) infection in the southeast part of Chongqing ,and provide information for its prevention and treatment .Methods 295 patients with HbsAg positive came from 110 families were selected and divided to different groups by gender and marital status .We investigated the infections of HBV in three generations of the immediate families .This research focused on the difference between mother-to-child transmission and father-to-child transmission ,the status of receiving HBV vaccine ,the morbidity and mortality of cirrhosis and hepatic carcinoma ,the cause of death ,and the impact of gender in three generations .Results Of the 110 cases ,the HBsAg positive rate for children with HBsAg positive mothers (more than 66 .7% ) was significantly higher than that with positive father (less than 1 .1% ) ,while there was no significant difference between male spouses and female spouses (22 .2% versus 20 .5% ,P>0 .05) .Only 23 .2% received HBV vac-cine and 2 .7% got immune globulin of HBV .8 .5% of the 295 persons had cirrhosis and 4 .4% of them had primary hepatocellular carcinoma (HCC);19 patients from 16 families died of liver diseases .39 cases of 110 patients got antiviral treatment regularly .Con-clusion As well as father-to-child transmission and close contact ,mother-to-child transmission contributed to familial HBV infec-tion ,and even more common .The high rate of familial HBV infection in this area was associated with low rate of vaccination and immune globulin of HBV .The leading cause of the high incidence of hepatocellular carcinoma and hepatic cirrhosis was substandard treatment .