泰兴市2005~2009年病毒性肝炎报告质量分析
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国家科技重大专项基金资助(2009ZX10004-904)


analysis of the quality of viral hepatitis case reporting in taixing county during 2005~2009
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    目的:通过分析江苏省泰兴市病毒性肝炎报告病例的有关特征,分析现有的病毒性肝炎诊断-报告中存在的问题,为规范病毒性肝炎的诊断和报告提供依据-方法:收集2005~2009年泰兴市通过国家疾病监测信息报告管理系统报告的所有病毒性肝炎病例有关病例临床分类-实验室分型,以及分类-分型证据等数据,应用excel 2007和spss 13.0软件对所收集的数据进行整理和分析-结果:泰兴市2005~2009年病毒性肝炎报告发病率在31.01/10万~46.63/10万之间;成人中的慢性乙型肝炎报告发病率在不同年间有明显波动,乙肝未分类报告发病率在6.25/10万~13.40/10万之间,占全部乙型肝炎报告病例的31.0%~70.2%-甲型肝炎总体呈缓慢下降趋势(趋势χ2=6.10,p < 0.05),而丙型肝炎呈明显上升趋势(趋势χ2=82.04,p < 0.01)-未分型肝炎在病毒性肝炎报告病例中所占比例在16.6%~23.0%之间-报告病例的复核诊断显示,甲肝和戊肝的病原分型诊断符合率为66.7%(12/18);乙肝急-慢性分类符合率为51.35%(19/37);报告的丙肝病例主要为无症状抗体阳性人群占68.42%(13/19);报告的未分型病例中有53.97%(34/63)可进行病原分型-结论:泰兴市5年间慢性乙肝报告发病率的变化缺乏合理性,提示医疗机构执行的病毒性肝炎报告标准不准确;病毒性肝炎分型-分类诊断的准确性也有待进一步提高-

    Abstract:

    objective:to find out the problems in diagnosis and case report and to provide useful information for standardization of viral hepatitis diagnosis and report by analyzing the reported viral hepatitis cases in taixing. methods:the clinical and laboratory classification of the viral hepatitis patients reported in taixing during 2005~2009 were collected and analyzed with excel 2007 and spss 13.0 retrospectively. results:the reported incidence rate of viral hepatitis was 31.01/100 000~46.63/100 000 during 2005~2009,which showed an increased trend. the incidence of chronic hepatitis b in adult was obviously unstable;the incidence of hepatitis b without classification was 6.25/100 000~13.40/100 000,accounting for 31.0%~70.2% of total. compared to 2005,the incidence of hepatitis c increased(linear trend χ2=82.04,p < 0.01) while the hepatitis a decreased gradually(linear trend χ2=6.10,p < 0.05). the non-abc hepatitis accounted for 16.6%~23.0% of hepatitis. according to medical records and laboratory testing,the percentage of correct diagnosis of hepatitis a and e was 66.7%(12/18). the classification coincidence rate of hepatitis b was 51.35%(19/37). most hepatitis c patients[68.42%(13/19)] were anti-hcv positive without symptoms. more than half of non-abc hepatitis(53.97%) could be reclassified. conclusion:the reported incidence of chronic hepatitis b in taixing during 2005~2009 was unjustified,this point out that the reported incidence of hepatitis was inaccurate and the accuracy of categorization,classification of hepatitis should be improved.

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张婷婷,翟祥军,许 可,鲍昌俊,王 毓,彭 红,汪 华.泰兴市2005~2009年病毒性肝炎报告质量分析[J].南京医科大学学报(自然科学版),2011,(4):540-543

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