中国社区成年人群HBsAg阳性者医疗和就诊行为及相关影响因素研究

摘要

Objective To analyze the characteristics of health-seeking behaviors and related influencing factors of the community-based hepatitis B surface antigen (HBsAg) positive adults,in China.Methods Based on the cohort formed by the HBsAg positive patients,in the national sero-survey project in 2006,we conducted a follow-up programs in 2010 and 2014.In the latest follow-up project,we carried out a cross-sectional study to collect information on health-seeking behaviors of the patients.Questionnaires would include information on clinic visits,diagnosis,regular physical examination and treatments,etc.We used the SPSS 18.0 software for data analysis.Results Totally,2 478 HBsAg positive adults (≥ 18 years old) were followed through,with 34.4％ (853/2 478) of them had visited the doctors and diagnosed after they were informed the status of HBsAg positivity,in the 2006-sero-survey program.Among patients who ever visiting the clinic,51.2％ (372/727) of them underwent at least medical examination once a year,with 31.5％ (229/727) of them received treatment.Furthermore,34.5％ (79/229) of the treated patients adopted the traditional Chinese medicine or medicine for ‘liver protection’.56.8％ (130/229) of the treated patients received antiviral drugs.Data from the binary logistic regression showed that the major influencing factors on clinic visits would include:age,level of education received and residencial areas (rural/urban).Conclusions Consciousness on health was low in those community-based HBsAg positive people.Standerdized management and clinical treatment programs should be set up accordingly.%目的 分析我国社区成年人群HBsAg阳性者的医疗和就诊行为特征,并探讨相关影响因素.方法 在2006年全国乙型肝炎(乙肝)血清流行病学调查建立的HBsAg阳性者队列基础上,分别于2010年和2014年开展队列随访调查.在2014年的随访中,采用横断面调查,通过问卷方法收集就诊医院的诊断、常规体检、治疗及用药等医疗就诊信息.使用SPSS 18.0软件分析数据,并对HBV感染者就诊行为的影响因素进行x2检验和二元logistic回归分析.结果 调查≥18岁HBsAg阳性者2 478例,其中853例(34.4％)有医院乙肝就诊史;在就诊的HBV携带者和慢性乙肝者中,51.2％ (372/727)能够做到每年至少1次体检;31.5％(229/727)具有治疗史,其中约34.5％(79/229)采用中医治疗或单纯保肝治疗,56.8％(130/229)采取抗病毒治疗.二元回归分析显示,年龄、文化程度和城乡分布是影响HBV感染者就诊的主要因素.结论 我国社区HBsAg阳性者的健康意识较低,其规范化随访体检和规范治疗仍面临挑战.