摘要:
目的 获得西安地区住院患者血清乙型肝炎病毒血清标志物的流行病学资料,为医院院内感染管理以及医护人员的防护提供依据.方法 利用Abott Architecti 4000SR(i4000SR)化学发光分析仪定量检测2015年10 593例住院病人血清中乙型肝炎病毒表面抗原(HBsAg)、乙型肝炎病毒表面抗体(HBsAb)、乙型肝炎病毒e抗原(HBeAg)、乙型肝炎病毒e抗体(HBeAb)和乙型肝炎病毒核心抗体(HBcAb),其中男性5 248例,女性5 345例.结果 HBV感染率为7.01%(743/10 593),受检者血清中HBV五项检测结果共有14种模式,其中感染期模式HBsAg,HBeAb和HBcAb均为阳性(模式3)占5.17%(548/10 593),HBsAg,HBeAg和HBcAb均为阳性(模式2)占1.34%(142/10 593),HBsAg和HBcAb均为阳性(模式4)占0.25%(27/10 593),其他非常见感染期模式占0.25%(26/10 593);恢复期模式中HBsAb阳性占21.02%(2227/105 93),HBsAb,HBeAb和HBcAb均阳性(模式6)占13.71%(1 452/10 593),HBsAb和HBcAb均阳性占15.07%(1 596/10 593);五项指标皆阴性的占31.38%(3 324/10 593).不同性别和不同年龄段的患者中HBV血清标志物结果模式阳性率差异均有统计学意义(P<0.05);感染模式2比例最高的科室为消化内科7.39%(36/487),感染模式3比例最高的科室为消化内科16.43%(80/487),HBsAb阳性比例最高的科室为胸外科89.23%(58/65).结论 了解住院患者乙肝感染特点为管理和控制院内HBV传播和推广乙肝疫苗接种提供了必要的临床资料数据,同时提示需要进一步采取有效措施来降低西安地区HBV的感染率.%Objective To obtain serological prevalence data for HBV markers in inpatients of Xi'an area with consequence of providing basis for nosocomial infection control and clinical stuff.Methods The serological markers of HBV (HBsAg,HBsAb,HBeAg,HBeAb,HBcAb) in serum of inpatients including 5 248 males and 5 345 females in 2015 were quantitatively detected by chemiluminescent analyzer ARCHITECT i4000SR.Results The infection rate of HBV was 7.01% (743/10593) and there were 14 patterns of HBV serum markers in inpatients.Of all patterns of HBV infection in this study,there were 5.17 % (548/10 593) with HBsAg+ HBeAb+ HBcAb+,1.34 % (142/10 593) with HBsAg+ HBeAg+ HBcAb+,0.25% (27/10 593) with HBsAg+HBcAb+ and 0.25% (26/10 593) with other uncommon ones.Of all patterns of HBV convalescent stage,there were 21.02% (2 227/10 593) with HBsAb+,13.71% (1 452/10 593) with HBsAb+HBeAb+ HBcAb+,and 15.07% (1 596/10 593) with HBsAb+HBcAb+.The percentage of five serum markers with negative was 31.38% (3 324/10 593).There existed statistical difference for patterns of HBV serum markers concerning gender and different age groups,respectively (P<0.05).The clinical departments with highest percentages of HBsAg-+-HBeAg+ HBcAb +-,HBsAg+ HBeAb+ HBcAb+ and HBsAb+ were department of gastroenterology with 7.39 % (36/487),department of gastroenterology with 16.43% (80/487) and thoracic surgery one with 89.23% (58/65),respectively.Conclusion This study provided clinical data of management and controlling the transmitting of HBV and promotion of HBV vaccination.Meanwhile it is necessary for government to take effective measures to reduce the infection rate of HBV in Xi'an area.