CAJ | 학술논문

目的了解维持性血液透析(MHD)患者HBV感染现状,并探讨相关影响因素.方法 2012年11月至2014年12月对山西省范围内16所医院血液透析中心1 524名MHD患者进行问卷调查,收集研究对象一般人口学特征及可能的HBV感染危险因素等,检测乙型肝炎(乙肝)血清学标志物5项.用SAS 9.3软件拟合两水平logistic回归模型分析HBV感染影响因素.结果 1 524名MHD患者的HBsAg阳性率为5.25％,HBV感染率为38.85％,不同医院之间感染率不同(t=2.33,P=0.034).拟合两水平logistic回归零模型分析得到组内相关系数(ICC) =0.1064,约10.64％的总变异是由医院不同引起.引入解释变量后的结果显示,MHD患者50 ～ 65岁组的HBV感染率高于0～35岁组(OR=1.560,95％CI:1.061～ 2.293);有拔牙史(OR=1.267,95％CI:1.009 ～1.591)和乙肝家族史(OR=2.052,95％CI:1.176～3.582)是HBV感染的危险因素;乙肝疫苗接种是HBV感染的保护因素(OR=0.734,95％CI:0.541 ～ 0.996).结论不同医院间MHD患者HBV感染存在差异,年龄组(50～ 65岁)、乙肝家族史及拔牙史为MHD患者HBV感染危险因素,接种乙肝疫苗为保护因素.
목적 료해유지성혈액투석(MHD)환자HBV감염현상,병탐토상관영향인소.방법 2012년11월지2014년12월대산서성범위내16소의원혈액투석중심1 524명MHD환자진행문권조사,수집연구대상일반인구학특정급가능적HBV감염위험인소등,검측을형간염(을간)혈청학표지물5항.용SAS 9.3연건의합량수평logistic회귀모형분석HBV감염영향인소.결과 1 524명MHD환자적HBsAg양성솔위5.25％,HBV감염솔위38.85％,불동의원지간감염솔불동(t=2.33,P=0.034).의합량수평logistic회귀령모형분석득도조내상관계수(ICC) =0.1064,약10.64％적총변이시유의원불동인기.인입해석변량후적결과현시,MHD환자50 ～ 65세조적HBV감염솔고우0～35세조(OR=1.560,95％CI:1.061～ 2.293);유발아사(OR=1.267,95％CI:1.009 ～1.591)화을간가족사(OR=2.052,95％CI:1.176～3.582)시HBV감염적위험인소;을간역묘접충시HBV감염적보호인소(OR=0.734,95％CI:0.541 ～ 0.996).결론 불동의원간MHD환자HBV감염존재차이,년령조(50～ 65세)、을간가족사급발아사위MHD환자HBV감염위험인소,접충을간역묘위보호인소.
Objective To understand the current status of HBV infection among patients receiving maintenance hemodialysis (MHD) and related influencing factors.Methods A questionnaire survey was conducted among 1 524 MHD patients selected from hemodialysis units in 16 hospitals in Shanxi province from 1 November 2012 to 30 December 2014 to collect their demographic information and learn about their risk behaviors.Serological detection was conducted for them.Statistical software package SAS 9.3 was used for fitting a two level logistic regression model to identify the independent risk factors for HBV infection.Results Among the 1 524 MHD patients,the positive rate of HBsAg was 5.25％ and the HBV infection rate was 38.85％.The HBV infection rate varied with hospital (t=2.33,P=0.034).The two-level logistic regression empty model showed that intra-class correlation coefficient was 0.106 4,indicating that about 10.64％ of the total variation was caused by the differences in hospitals.After introducing explaining variables,the results showed that the HBV infection rate in age group 50-65 years group was higher than that in age group 0-35 years (OR=1.560,95％CI:1.061-2.293).Family history of HBV infection and dental surgery were the risk factors for HBV infection (OR=2.052 and 1.267,95％CI:1.176-3.582 and 1.009-1.591).Receiving HepB vaccination was a protective factor for HBV infection (OR=0.734,95％ CI:0.541-0.996).Conclusion The HBV infection rates were different among MHD patients in different hospitals.Old age (50-65 years),family history of HBV infection and dental surgery were the risk factors and receiving HepB vaccination was a protective factor for HBV infection among MHD patients.