摘要
目的 了解HBV携带者进展为慢性乙型肝炎（慢性乙肝）患者的流行病学特征，为推进HBV携带者的社区规范管理提供依据。方法 2012-2014年对在江苏省传染病防治示范区HBV携带者队列开展定期随访，并行B超检查及ALT、HBsAg、抗-HBe，HBeAg、乙肝病毒核酸（HBV DNA）检测。通过Cox回归分析携带者进展为慢性乙肝的特征及影响因素，通过方差分析和配对t检验分析携带者进展为慢性乙肝时HBeAg变化特征与HBV DNA的关系。结果 2012年4 069例HBV携带者[平均年龄（52.0±12.8岁）]随访到2014年时1 444例进展为慢性乙肝，进展率为21.0/100人年。男性携带者慢性乙肝进展率（24.8/100人年）高于女性（18.4/100人年）；HBV DNA〈2 000 IU/ml的携带者慢性乙肝进展率为19.0/100人年，低于2 000-19 999 IU/ml者（23.7/100人年）、20 000-199 999 IU/ml者（31.1/100人年）和≥200 000 IU/ml者（33.8/100人年）。通过Cox回归分析，除性别外，HBV DNA是携带者进展为慢性乙肝的影响因素（P〈0.05）。40.7%的HBeAg阳性携带者进展为慢性乙肝时发生了HBeAg转换，1.7%的HBeAg阴性携带者进展为慢性乙肝时发生了HBeAg阳转。结论 江苏省传染病防治示范区HBV携带者慢性乙肝进展率为21.0/100人年，建议对HBV携带者定期检查ALT、B超和HBV DNA，可提高早发现慢性乙肝的可能性。
Objective To understand epidemiological characteristics and influencing factors of hepatitis B virus （HBV） carriers progressing to chronic hepatitis B in Jiangsu, and provide evidence for regular management of HBV carriers. Methods From 2012 to 2014, a cohort study was conducted among the HBV carriers in an area in Jiangsu province. Association between HBV carriers＇demographics, HBeAg level and HBV DNA detection result and incidence of chronic hepatitis B was analyzed by Cox regression analyses. Results In 2012, a total of 4 069 HBV carriers aged （52.0±12.8） years were surveyed. By 2014, chronic hepatitis B had developed in 1 444 cases, with the rate of 21.0/100 person-years. Cox regression analysis indicted that, in addition to gender, HBV DNA level was an important influencing factor for the incidence of chronic hepatitis B （P〈0.05）. In HBeAg positive carriers progressing to chronic hepatitis, 40.7% had HBeAg seroconversion, and reversion of HBeAg occurred in 1.7% of HBeAg negative carriers. Conclusion Chronic hepatitis B developed in more than 1/5 （21.0/100 person-years） of HBV carriers in the surveyed area in Jiangsu. It is suggested to conduct regular ALT, HBV DNA detection and B ultrasonic examination in HBV carriers for the early detection of chronic hepatitis B.
出处
《中华流行病学杂志》
CAS
CSCD
北大核心
2016年第11期1463-1467,共5页
Chinese Journal of Epidemiology
基金
国家科技重大专项（2009ZX10004-904
2011ZX10004-902
2013ZX10004-905）
国家自然科学基金（81502861）
