| 陈静.杭州市2015-2024年从业人员HEV-IgM抗体阳性情况调查[J].浙江中西医结合杂志,2025,35(9): |
| 杭州市2015-2024年从业人员HEV-IgM抗体阳性情况调查 |
| InvestigationonacuteinfectionofHepatitisEamongpractitionersinHangzhoucityfrom2015to2024 |
| 投稿时间：2025-07-31 修订日期：2025-09-09 |
| DOI： |
| 中文关键词: 戊型肝炎 从业人员 健康体检 HEV-RNA 隐性感染 预防感染 |
| 英文关键词:HepatitisE Practitioners Physicalexamination Infection HEV-RNA Recessive infection Preventionandcontrol |
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| 中文摘要: |
| 摘要：目的?分析杭州市从业人员HEV-IgM抗体阳性人员的流行特征及影响因素，为戊肝防控提供科学依据。方法?对2015-2024年杭州市职业病防治院362496人次从业人员的血清HEV-IgM抗体检测结果进行流行病学分析，并追踪调查阳性人员的临床症状与转归。结果?共检出HEV-IgM抗体阳性286例（提示急性HEV感染可能，最终确诊需结合病原学或临床诊断），总阳性率为7.89/万人次。2015-2024年HEV-IgM抗体阳性率从2017年的7.89/万人次降至2023年的7.89/万人次，呈显著下降趋势（χ2=49.060，P<0.0001）。男性阳性率（7.89/万人次）略低于女性（7.89/万人次），但差异无统计学意义（P＞0.05）；阳性人员集中于21-50岁劳动年龄人群（占85.66%），食品行业从业人员占比最高（86.01%）。食品行业阳性率为7.89/万人次，低于公共场所服务行业（7.89/万人次），高于其它行业（7.89/万人次）。HEV-IgM阳性者中，74.83%为无临床症状的隐性感染状态（未通过HEV-RNA验证），仅9.79%伴肝功能异常。病例追踪显示，58.04%患者就诊，6.29%带病在岗，9.44%失联。HEV-IgM抗体阳性同时伴HAV-IgM抗体阳性3例，同时感染率为7.89/万人次。结论?杭州市从业人员HEV-IgM抗体阳性率呈下降趋势，防控成效显著；感染以隐性为主且集中于食品行业。建议在现有HEV-IgM筛查基础上，结合HEV-RNA复核提高确诊率，强化对公共卫生行业的针对性监管，并推动高危人群疫苗接种，构建‘筛查-确诊-干预’闭环体系。 |
| 英文摘要: |
| Objective?To analyze the epidemiological characteristics and influencing factors of acute hepatitis E virus (HEV) infection among practitioners in Hangzhou, so as to provide scientific basis for the prevention and control of hepatitis E.Methods?Epidemiological analysis was conducted on the serum HEV-IgM antibody detection results of 362,496 practitioners in Hangzhou Occupational Disease Prevention and Control Hospital from 2015 to 2024, and the clinical symptoms and outcomes of positive cases were tracked. Results?A total of 286 cases were found positive for HEV-IgM antibodies (indicating a possible acute HEV infection; a final diagnosis requires a combination of etiological or clinical diagnosis), with a total positive rate of 7.89 per 10,000. From 2015 to 2024, the positive rate of HEV IgM antibody decreased from 13.89/10000 in 2017 to 3.96/10000 in 2023, showing a significant downward trend (χ2 =49.060, P<0.0001). The positive rate among men (7.50 per 10,000) was slightly lower than that among women (8.35 per 10,000), but the difference was not statistically significant (P > 0.05). The positive cases were mainly concentrated among the working-age population aged 21 to 50 (accounting for 85.66%), with the highest proportion among food industry workers (86.01%). The positive rate in the food industry was 7.75 per 10,000, lower than that in the public service industry (9.66 per 10,000), but higher than that in other industries (5.63 per 10,000). Among the HEV-IgM positive cases, 74.83% were in an asymptomatic latent infection state (not verified by HEV-RNA), and only 9.79% had abnormal liver function. Case tracking showed that 58.04% of the patients sought medical treatment, 6.29% were working while ill, and 9.44% were untraceable. Three cases were positive for both HEV-IgM and HAV-IgM antibodies, with a co-infection rate of 0.163 per 10,000. Conclusion?The positive rate of HEV-IgM antibody among practitioners in Hangzhou City shows a downward trend, and the prevention and control effect is remarkable. Infections are mainly asymptomatic and concentrated in the food industry. It is suggested that on the basis of the existing HEV-IgM screening, combined with HEV-RNA review to increase the diagnosis rate, strengthen targeted supervision of the public health industry, promote vaccination among high-risk groups, and build a closed-loop system of "screening - diagnosis - intervention". |
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