接触猪职业人群和对照人群戊型肝炎感染率比较研究

近年来戊型肝炎（Hepatitis E,HE）被怀疑是一种人兽共患病,猪是其重要的宿主.通过在HE流行区比较接触猪人群和对照人群HE感染率,评价接触猪对人群的HE感染的风险.在浙江省北部某县采用限制研究对象的群组匹配的横断面调查,对同地区同年龄段的接触猪人群和对照人群进行问卷调查,采集血液并检测抗HE抗体.研究发现,接触猪人群和对照人群的年龄大致相当,但前者男性比例较高.接触猪人群抗HE抗体感染率（254/340,74.71%）明显高于对照人群（319/512,62.30%）.经过分层分析和多因素非条件Logistic回归分析,平衡性别和年龄因素后,接触猪仍能增加约50%人群的HE感染风险.随着接触年数的增加,其风险也增加,接触猪5～14年和15年以上人群分别比对照人群增加65%和157%的HE感染风险.接触猪人群男性、女性和合计的标化感染率分别为72.30%、65.67%和70.92%,均高于对照人群（69.87%、51.82%和60.80%）,尤其以女性更为明显.在HE流行区,接触猪可能增加人群HE感染风险,对女性的影响可能较大,随着接触猪年数的增加HE感染的风险也增加.由于本研究采用病因和结果同时出现的横断面研究,确切的接触猪和HE感染的关系需要建立合适的接触猪人群队列并结合详细的接触猪暴露调查得到阐明.

The Comparison on Prevalence of IgG-class Antibodies to Hepatitis E between Swine Contact Population and the Control

Recently hepatitis E(HE) has been highly suspected as a kind of zoonosis,and swine plays an important role in its transmission.In order to evaluate population risk of hepatitis E through swine contact,the comparison on prevalence of IgG-class antibodies to hepatitis E between swine contact population and the control was conducted in hepatitis E endemic area.A group-matched cross sectional study was used to investigate the related background information on the two populations above and 5 millimeter blood was collected under informed consent and further tested with HEV IgG kits.From the study,the age distribution was similar between the two populations,but higher sex ratio was seen in swine contact population.The prevalence of IgG-class antibodies to hepatitis E was higher in swine contact population(254/340,74.71%) than that in control(319/512,62.30%),and the odd ratio(OR) and its 95% confidential limits in population risk of hepatitis E through swine contact was 1.55(1.12,2.16) after adjustment of sex and age.Longer swine contact years increased this risk at 65% and 157% separately for the population with 5-14 year swine contact and more than 15 years.And the standardized morbidity was higher in swine contact population than that in control,especially among the female swine contact population.Based on above,swine contact will probably increase the risk of population infection of hepatitis E,especially for the female,in hepatitis E endemic area.This risk increased with the time of swine contact.Due to the limitation of cross sectional study, a conclusive statement on the relationship between swine contact and population risk of hepatitis E will be clarified through the setup of suitable swine contact population cohort study and detailed investigation of swine exposure status.