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为了评估中国目前新生儿乙型肝炎 (乙肝 )疫苗预防接种阻断乙肝病毒 (HBV)慢性感染的成本 效果及其影响因素 ,以近 1 1年中国年平均新生儿人口作为观察队列 ,按HBV感染本底和自然转归来推算HBV自然感染的后果 ,以新生儿乙肝疫苗保护效果为 90 %估计干预后HBV感染状况 ,以每接种 1 0 0 0份 (3剂 ,下同 )乙肝疫苗预期所阻断的慢性携带者人数和慢性肝病患者例数作为乙肝疫苗预防HBV慢性感染的成本 效果。结果显示 :中国HBV慢性持续感染的分布有明显的地区性 ;中流行区HBV慢性携带者的流行率比特高流行区低 2 5倍 ;HBV慢性携带者流行率高的人群 ,乙肝疫苗的成本 效果相对较高。同样接种 1 0 0 0份乙肝疫苗 ,在中流行区可减少 67名慢性携带者和 1 7例慢性肝病患者 ,在特高流行区则可阻断 1 64名慢性携带者和 41例慢性肝病患者。中国目前推广新生儿乙肝疫苗预防接种 ,平均每 1 0 0 0份乙肝疫苗将可减少 98名慢性携带者和 2 5例慢性肝病患者。中国各地目前推广乙肝疫苗预防接种的成本 效果均非常高。同时 ,乙肝疫苗的成本 效果与免疫策略和HBV感染的流行率密切相关。
In order to assess the cost-effectiveness and its influential factors of blocking hepatitis B (HBV) vaccination against neonatal hepatitis B virus infection in China in recent years, taking the annual average neonatal population in China as an observation cohort in the recent 11 years, End and natural outcome to estimate the consequences of natural HBV infection, HBV infection was estimated at 90% of neonatal hepatitis B vaccine intervention, and was blocked with the expected vaccine per 100 000 doses (3 doses) Of chronic carriers and the number of patients with chronic liver disease as a hepatitis B vaccine to prevent the cost-effectiveness of chronic HBV infection. The results showed that the distribution of chronic persistent HBV infection in China was obviously regional; the prevalence of chronic HBV carriers in endemic areas was 25 times lower than that in endemic areas; the cost-effectiveness of hepatitis B vaccine in people with high prevalence of chronic HBV carriers Relatively high. The same vaccination of 100 doses of hepatitis B vaccine reduced the incidence of 67 chronic carriers and 17 patients with chronic liver disease in endemic areas and 164 patients with chronic carriers and 41 patients with chronic liver disease in endemic areas . Currently, vaccination against newborns is being promoted in China. On average, 100 hepatitis B vaccines will reduce 98 chronic carriers and 25 patients with chronic liver disease. Currently, the cost-effectiveness of vaccination against hepatitis B vaccine is very high throughout China. Meanwhile, the cost-effectiveness of hepatitis B vaccine is closely related to the prevalence of immunization strategies and HBV infection.