摘要
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1524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SAS9.3软件拟合两水平logistic回归模型分析HBV感染影响因素。结果1524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=O．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。
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 （0R=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.
出处
《中华流行病学杂志》
CAS
CSCD
北大核心
2015年第5期510-514,共5页
Chinese Journal of Epidemiology
基金
国家科技重大专项（2012ZX10002001-003-004）
山西医科大学博士启动基金（03201109）
山西省回国留学人员科研资助（2013-056）
关键词
血液透析
乙型肝炎病毒感染
多水平模型
Hemodialysis
Hepatitis B virus infection
Multi-level analysis model
