贵州省1115户居民家庭结构和乙肝感染家庭聚集性关系研究
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摘要
目的:探讨贵州省少数民族地区家庭结构与乙肝感染家庭聚集性的关系。方法:采用多阶段整群随机抽样的方法,从贵州省少数民族地区抽取1 115户家庭1 629人进行调查,并采集5 mL静脉血,检测乙肝五项指标;采用二分类非条件Logistic回归模型分析,评估不同家庭结构和乙肝感染家庭聚集性关系。结果:3代同堂家庭乙肝感染家庭聚集性率最高(56.8%),隔代家庭HBV感染率最高(57.7%),不同家庭结构乙肝感染家庭聚集性差异有统计学意义(χ~2=38.983,P<0.01);Logistic回归分析在调整相关危险因素后结果显示,与传统家庭相比,隔代家庭(OR=2.544,95%CI为1.254～5.160)、3代同堂家庭(OR=3.984,95%CI为2.497～6.357)、一起生活的人有HBsAg阳性(OR=7.379,95%CI为4.741～11.485),是乙肝感染的危险因素(P<0.05);接种过乙肝疫苗(OR=0.448,95%CI为0.207～0.972)、过去一年家庭总收入≥30 000元(OR=0.408,95%CI为0.202～0.825)是家庭聚集性的保护因素(P<0.05)。结论:贵州省少数民族地区隔代家庭和3代同堂家庭是乙肝感染家庭聚集性的高危人群。
Objective: To explore the association of family structure with family aggregation of hepatitis B Virus(HBV) infection in ethnic minority areas of Guizhou Province. Methods: 1 629 permanent residents were randomly enrolled from 1 315 households in Guizhou province using a multi-stage cluster random sampling method. 5 mL venous blood from every individual was collected to detect five HBV serological indexes. These indexes were analyzed using a two-class unconditional logistic regression model to calculate OR(95% CI) and assess the association of family structures with HBV infection. Results: Among four different family structures, the aggregation rate of HBV infection was the highest rate(56.8%) in the families with three generations living together(FTG), and the rate of HBV infection was the highest rate(57.7%) in the families with only grandparents and children(FGC). One factor chi-square test showed there was a statistically significant difference in the aggregation of HBV infection among different family structures(χ~2=38.983,P<0.01). After adjusting the relevant risk factors, two classified non conditional Logistic regression analysis showed that FGC(OR=2.544,95%CI was 1.254～5.160), FTG OR=3.984,95%CI was 2.497～6.357)and living with people who have HBsAg positive(OR=7.379,95%CI was 4.741～11.485)were risk factors of family aggregation of HBV infection(P<0.05). Besides, inoculation of HBV vaccine(OR=0.448,95%CI was 0.207～0.972) and family yearly income ≥ $30 000(OR=0.408,95%CI:0.202～0.825) are protective factors from HBV infection(P<0.05). Conclusion: FGC and FTG members are at high-risk for family aggregation of HBV infection in Guizhou ethic minority areas.
Objective: To explore the association of family structure with family aggregation of hepatitis B Virus(HBV) infection in ethnic minority areas of Guizhou Province. Methods: 1 629 permanent residents were randomly enrolled from 1 315 households in Guizhou province using a multi-stage cluster random sampling method. 5 mL venous blood from every individual was collected to detect five HBV serological indexes. These indexes were analyzed using a two-class unconditional logistic regression model to calculate OR(95% CI) and assess the association of family structures with HBV infection. Results: Among four different family structures, the aggregation rate of HBV infection was the highest rate(56.8%) in the families with three generations living together(FTG), and the rate of HBV infection was the highest rate(57.7%) in the families with only grandparents and children(FGC). One factor chi-square test showed there was a statistically significant difference in the aggregation of HBV infection among different family structures(χ~2=38.983,P<0.01). After adjusting the relevant risk factors, two classified non conditional Logistic regression analysis showed that FGC(OR=2.544,95%CI was 1.254～5.160), FTG OR=3.984,95%CI was 2.497～6.357)and living with people who have HBsAg positive(OR=7.379,95%CI was 4.741～11.485)were risk factors of family aggregation of HBV infection(P<0.05). Besides, inoculation of HBV vaccine(OR=0.448,95%CI was 0.207～0.972) and family yearly income ≥ $30 000(OR=0.408,95%CI:0.202～0.825) are protective factors from HBV infection(P<0.05). Conclusion: FGC and FTG members are at high-risk for family aggregation of HBV infection in Guizhou ethic minority areas.
引文
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[2] ZAMPINO R,BOEMIO A,SAGNELLI C,et al.Hepatitis B virus burden in developing countries[J].World J Gastroenterol,2015,21(42):11941-11953.
[3] ZHANG E L,GU J,ZHANG Z Y,et al.MicroRNA expression profiling in patients with hepatocellular carcinoma of familial aggregation and hepatitis B virus infection[J].Oncol Lett,2017,14(1):971-976.
[4] 闵定玉,黄文湧,杨敬源,等.贵州少数民族人群HBV感染家庭聚集性及影响因素分析[J].中国公共卫生,2016,32(2):183-187.
[5] 孔毅,丁峥嵘,罗梅,等.云南省乙型肝炎病毒感染危险因素Logistic回归模型分析[J].中国疫苗和免疫,2012,18(2):123-126.
[6] 邢茂源,温勇.家庭结构视角下家庭健康自评及影响因素研究[J].人口与社会,2018,34(3):101-110.
[7] WATERWORTH P,ROSENBERG M,BRAHAM R,et al.The effect of social support on the health of Indigenous Australians in a metropolitan community[J].Soc Sci Med,2014,119:139-146.
[8] LI L W,ZHANG J,LIANG J.Health among the oldest-old in China:which living arrangements make a difference?[J].Soc Sci Med,2009,68(2):220-227.
[9] 杨进业,沈立萍,莫兆军,等.乙肝疫苗长期免疫地区乙肝病毒感染家庭聚集性变化趋势的观察[J].应用预防医学,2007,13(1):8-10.
[10]云雪霞,刘建华,蔡衍珊,等.广州地区甲型、乙型、戊型肝炎病毒感染家庭聚集性特征分析[J].现代预防医学,2011,38(19):3877-3880.
[11]罗贤贵.流动与变迁:民族地区农村家庭结构嬗变研究——以贵州省9个少数民族村为例[J].农村经济,2015(8):109-113.
[12]龚玲.三代同堂家庭祖辈和父辈共同养育研究[D].上海:华东师范大学,2017.
[13]黄勇,刘蔚丹,崔征.西南农村家庭网络结构变迁下住区规划设计的几点思考[J].现代城市研究,2015,30(4):35-40.
[14]冉莉.铜仁市不同家庭结构老年人健康状况调查及影响因素[J].中国老年学杂志,2012,32(8):1663-1664.
[15]黎健,刘景一,胡家瑜,等.上海市乙肝病毒感染家庭聚集性及感染模式研究[J].中华疾病控制杂志,2013,17(8):681-683.
[16]BLUMBERG B S.Complex interactions of hepatitis B virus with its host and environment[J].J R Coll Physicians Lond,1995,29(1):31-40.
[17]徐龙,吴敏,邹鲁,等.江西部分地区慢性HBV感染的家族聚集性分析[J].江西医药,2017,52(9):831-832.
[18]胡莉萍,刘德平,陈钦艳,等.隐匿性乙型肝炎病毒感染可通过密切接触传播[J].应用预防医学,2016,22(2):97-101.
[19]陈胜华,江金华,骆碧珍,等.乳源县瑶族人群乙型肝炎病毒感染危险因素分析[J].中国热带医学,2015,15(6):692-694.
[20]孟庆华,侯维.2015年版《慢性乙型肝炎防治指南》——慢性乙型肝炎抗病毒治疗指南解读[J].中国全科医学,2016,19(14):1613-1615.
[21]徐英,刘军,刘建华.乙型肝炎家庭成员健康管理相关研究进展[J].中国病毒病杂志,2017,7(6):459-464.
[22]李锋平,王伟明,苏培聪,等.泉州市居民乙肝病毒感染现状及影响因素分析[J].中国公共卫生,2011,27(10):1223-1225.