2005—2023年上海市杨浦区急性病毒性肝炎流行特征与趋势分析

摘要/Abstract

摘要：

目的了解2005—2023年上海市杨浦区急性病毒性肝炎流行病学特征，分析发病率变化趋势，为杨浦区下阶段急性病毒性肝炎防制工作提供科学依据。方法收集中国疾病预防控制信息系统报告的录入日期在2005年1月—2023年12月、现住址为杨浦区全部病毒性肝炎病例，用Excel 2007和SPSS 18.0进行数据整理统计分析，主要包括描述统计分析、χ²检验、趋势χ²检验、移动平均线等，对上海市杨浦区急性病毒性肝炎疫情资料进行分析。结果 2005—2023年上海市杨浦区急性病毒性肝炎年均发病率为10.32/10万，呈下降趋势（χ²_趋势=493.633，P<0.01）；甲型肝炎发病率低水平波动（χ²=44.743，P<0.01）；急性乙型肝炎发病率大幅下降（χ²_趋势=175.981，P<0.01）；急性丙型肝炎发病率大幅下降后走平（χ²_趋势=47.131，P<0.01）；戊型肝炎发病率小幅上升（χ²=59.866，P<0.01）；未分型肝炎发病率大幅下降（χ²_趋势=905.702，P<0.01）。各型病毒性肝炎构成比近20年发生显著变化，戊型肝炎逐渐取代未分型肝炎，成为杨浦区急性病毒性肝炎优势型别。急性病毒性肝炎发病数男女性别比1.50 ∶ 1，男女发病率差异有统计学意义（χ²=95.971，P<0.01）；发病以40~<70岁人群为主，各年龄人群发病率差异有统计学意义（χ²=307.403，P<0.01）。杨浦区12个街道均有急性病毒性肝炎发病，发病数最高的2个街道为殷行街道和五角场街道，发病高峰在每年3月。结论 2005—2023年杨浦区急性病毒性肝炎年均发病率呈下降趋势，急性病毒性肝炎型别构成发生显著变化，戊型肝炎已成为杨浦区急性病毒性肝炎优势型别，发病率小幅波动上升。提示，杨浦区需继续加强急性病毒性肝炎监测工作，防范急性病毒性肝炎聚集性疫情发生，可考虑在高危人群中开展健康宣教、疫苗接种等干预措施，注意加强戊型肝炎监测防控力度。

关键词: 病毒性肝炎, 发病率, 发病数, 流行特征, 趋势

Abstract:

Objective To understand the epidemiological characteristics of acute viral hepatitis in Yangpu District of Shanghai from 2005 to 2023，and analyze the change and trend of the incidence，so as to provide scientific basis for the prevention and control work of acute viral hepatitis in the next stage in Yangpu District of Shanghai. Methods All viral hepatitis cases with current addresses in Yangpu District reported online from January 2005 to December 2023 were collected from the China Disease Prevention and Control Information System. Excel 2007 and SPSS 18.0 softwares were used for data sorting and statistical analysis. Statistical methods mainly include descriptive statistical analysis，Chi-square test，Chi-square trend test，moving average and so on. The epidemic data of acute viral hepatitis in Yangpu District of Shanghai from 2005 to 2023 were analyzed. Results From 2005 to 2023，the average annual incidence of acute viral hepatitis in Yangpu district of Shanghai was 10.32 per 100 000 people，showing a downward trend（χ²_trend=493.633，P<0.01）. The incidence rate of hepatitis A fluctuated at a low level（χ²=44.743，P<0.01），the incidence rate of acute hepatitis B showed a significant downward trend（χ²_trend=175.981，P<0.01），the incidence rate of acute hepatitis C declined significantly and then leveled off（χ²_trend=47.131，P<0.01），the incidence rate of hepatitis E increased slightly（χ²=59.866，P<0.01），and the incidence rate of undifferentiated hepatitis showed a significant downward trend（χ²_trend=905.702，P<0.01）. The composition of acute hepatitis types had undergone significant changes in the past two decades，with hepatitis E gradually replacing undifferentiated hepatitis as the dominant type of acute hepatitis in Yangpu District. The male to female ratio of viral hepatitis incidence was 1.50 ∶ 1，and the difference in incidence rate between men and women was statistically significant（χ²=95.971，P<0.01）. The main population affected was those aged 40-<70 years old，and the difference in incidence rate among different age groups was statistically significant（χ²=307.403，P<0.01）. Acute viral hepatitis occurred in all 12 streets of Yangpu District，with Yinhang Street and Wujiaochang Street having the highest number of reported cases，with the peak incidence occurring in March each year. Conclusion The incidence rate of acute viral hepatitis in Yangpu District showed a downward trend from 2005 to 2023，and the proportion of acute viral hepatitis composition changed significantly. Hepatitis E has become the dominant type of acute viral hepatitis in Yangpu District，with the incidence rate rising slightly. It is suggested that Yangpu District should continue to strengthen the surveillance of acute viral hepatitis in the future and prevent the occurrence of acute viral hepatitis clusters. Health education，vaccination and other intervention measures can be considered among high-risk populations，and attention should be paid to strengthening the surveillance，prevention and control of hepatitis E.

Key words: Viral hepatitis, Incidence, Incident number, Epidemiological characteristics, Trend

中图分类号:

R181.8+1

张珍, 李辉, 叶薇薇, 成俊. 2005—2023年上海市杨浦区急性病毒性肝炎流行特征与趋势分析. [J]职业与健康, 2026, 42(19): 2648-2653.

ZHANG Zhen, LI Hui, YE Weiwei, CHENG Jun. Epidemic characteristics and trend analysis of acute viral hepatitis in Yangpu District of Shanghai from 2005 to 2023. [J]OCCUPATION AND HEALTH, 2026, 42(19): 2648-2653.

图/表 7

图1 上海市杨浦区急性病毒性肝炎发病情况

图2 上海市杨浦区各型病毒性肝炎发病率

图3 上海市杨浦区急性病毒性肝炎发病率移动平均线

图4 上海市杨浦区急性病毒性肝炎发病型别构成

表1 2005—2023年上海市杨浦区急性病毒性肝炎性别和年龄发病情况

人口学特征	发病数（例）	未发病数（例）	发病率（1/10万）	χ²值	P值
性别				95.971	<0.001
男	1 516	10 285 635	14.74
女	1 008	10 157 574	9.92
年龄（岁）				307.403	<0.001
0~<10	15	1 149 568	1.30
10~<20	55	1 328 190	4.14
20~<30	263	2 891 251	9.10
30~<40	322	2 615 652	12.31
40~<50	422	2 652 662	15.91
50~<60	618	3 844 909	16.07
60~<70	489	3 212 995	15.22
70~<80	231	1 709 819	13.51
≥80	109	1 038 164	10.50

图5 2005—2023年上海市杨浦区急性病毒性肝炎发病地区分布

图6 2005—2023年上海市杨浦区急性病毒性肝炎发病时间分布

参考文献 24

[1]	中华预防医学会促进消除病毒性肝炎工作委员会. 中国消除病毒性肝炎公共卫生危害的进展[J]. 中国病毒病杂志, 2023, 13(5):327-336.
[2]	郭琪, 张悦, 苏华林, 等. 2010-2020年上海市闵行区病毒性肝炎流行病学特征分析及预测[J]. 公共卫生与预防医学, 2021, 32(5):88-92.
[3]	李言飞, 马家奇. 中国疾病预防控制信息系统问题分析与对策[J]. 中国卫生信息管理杂志, 2013, 10(3):230-257.
[4]	邵毅, 高玥, 张莹, 等. 传染病实时监测报告系统在综合医疗机构应用的效果评价[J]. 首都公共卫生, 2023, 17(5):274-278.
[5]	沈福杰, 舒敏, 王曙, 等. 2007-2012年上海市黄浦区急性病毒性肝炎流行特征[J]. 职业与健康, 2014, 30(14):1925-1927.
[6]	杨吉星, 于晓楠, 汤显. 上海市虹口区1956-2014 年急性病毒性肝炎流行特征分析[J]. 疾病监测与控制杂志, 2016, 10(6):431-433.
[7]	NAYAGAM S, SHIMAKAWA Y, LEMOINE M. Mother-to-childtransmission of hepatitis B:What more needs to be done to eliminate it around the world[J]. J Viral Hepat, 2020, 27(4):342-349. DOI URL
[8]	郑贤义. 乙型肝炎疫苗的应用及研究[J]. 重庆医学, 2016, 45(26):3719-3721.
[9]	学燕, 陈钦艳, 张陆娟, 等. 广西隆安县新生儿乙肝疫苗长期免疫效果研究[J]. 应用预防医学, 2020, 26(6):458-462.
[10]	ANKCORN M J, TEDDER R S. Hepatitis E:the current state of play[J]. Transfus Med, 2017, 27(2):84. DOI URL
[11]	LANCET T. Growing concerns of hepatitis E in Europe[J]. Lancet, 2017, 390(10092):334. DOI PMID
[12]	KHUROO M S, KHUROO M S, KHUROO N S. Hepatitis E:Discovery,global impact,control and cure[J]. World J Gastroenterol, 2016, 22(31):7030-7045. DOI URL
[13]	MIRAZO S, RAMOS N, MAINARDI V, et al. Transmission,diagnosis,and management of hepatitis E:An update[J]. Hepat Med, 2014, 6(6):45-59.
[14]	REIN D B, STEVENS G A, THEAKER J, et al. The global burden of hepatitis E virus genotypes 1a and 2 in 2005[J]. Hepatology, 2012, 55(4):988-997. DOI URL
[15]	谭超, 李海, 方钟燎, 等. 广西2005-2014年戊型肝炎流行病学分析[J]. 中国热带医学, 2016, 16(12):1187-1189. DOI
[16]	陈奕娟, 秦淑文. 戊型肝炎流行病学研究新进展[J]. 预防医学, 2016, 28(10):1014-1018.
[17]	许磊, 高强, 张正, 等. 2004-2023年江苏省淮安市甲型、戊型病毒性肝炎流行病学特征分[J]. 现代预防医学, 2025, 52(7):1324-1327.
[18]	郑亚, 李亚飞, 姚星妹, 等. 戊型肝炎疫苗临床研究进展[J]. 病毒学报, 2018, 34(6):951-957.
[19]	徐晓燕. 2005-2015年常熟市病毒性肝炎流行病学特征[J]. 职业与健康, 2017, 33(5):642-644.
[20]	康怀雄, 刘趋振, 刘世日. 韶关市2000-2004年病毒性肝炎流行特征分析[J]. 华南预防医学, 2005, 31(3):17-18.
[21]	邵杏芳, 田建国, 黎桂福, 等. 上海市青浦区2007-2012年监测点医院病毒性肝炎流行病学分析[J]. 上海预防医学, 2013, 25(10):548-550.
[22]	邓秋云. 成人乙肝疫苗接种及免疫效果概述[J]. 现代预防医学, 2017, 44(14):2647-2650.
[23]	王琳, 胡进, 曹慎. 上海市杨浦区2005-2007年病毒性肝炎流行病学分析[J]. 上海预防医学, 2009, 21(5):197-198.
[24]	陈秀兰, 娄东华, 姚根红, 等. 2005-2013年泰兴市病毒性肝炎流行病学分析[J]. 职业与健康, 2014, 30(21):3069-3071.