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代雪梅, 张茜, 张璇, 等. 糖尿病患者HBV新发感染风险的行为影响因素分析[J]. 四川大学学报(医学版), 2021, 52(5): 772-777. DOI: 10.12182/20210960301
引用本文: 代雪梅, 张茜, 张璇, 等. 糖尿病患者HBV新发感染风险的行为影响因素分析[J]. 四川大学学报(医学版), 2021, 52(5): 772-777. DOI: 10.12182/20210960301
DAI Xue-mei, ZHANG Xi, ZHANG Xuan, et al. Study on Behavioral Factors Affecting the Risk of New HBV Infection among Diabetic Patients[J]. Journal of Sichuan University (Medical Sciences), 2021, 52(5): 772-777. DOI: 10.12182/20210960301
Citation: DAI Xue-mei, ZHANG Xi, ZHANG Xuan, et al. Study on Behavioral Factors Affecting the Risk of New HBV Infection among Diabetic Patients[J]. Journal of Sichuan University (Medical Sciences), 2021, 52(5): 772-777. DOI: 10.12182/20210960301

糖尿病患者HBV新发感染风险的行为影响因素分析

Study on Behavioral Factors Affecting the Risk of New HBV Infection among Diabetic Patients

  • 摘要:
      目的  探讨糖尿病患者乙型肝炎病毒(hepatitis B virus, HBV)新发感染的行为影响因素,为降低糖尿病患者HBV新发感染风险提供依据。
      方法  采用巢式病例对照研究方法,对4 586名糖尿病患者进行随访观察,以随访观察期内新发生HBV感染的114名糖尿病患者为病例组,按年龄±2岁,从队列人群中以1∶2的比例匹配228名同期未发生HBV感染的糖尿病患者为对照组。对队列人群进行问卷调查和实验室检查,问卷内容包括乙肝家族史、外伤史、受/献血史、个体相关行为特征、糖尿病严重程度和糖尿病治疗管理相关行为等,同时采用酶联免疫吸附法(enzyme-linked immunosorbent assay, ELISA)对队列人群的血标本进行乙肝表面抗原(hepatitis B surface antigen, HBsAg)检测。采用条件logistic回归模型分析影响糖尿病患者HBV新发感染的相关行为因素。
      结果  病例组与对照组年龄的中位数分别为64岁和66岁,两组的性别、年龄、民族、职业和文化程度构成差异均无统计学意义(P>0.05)。多因素分析结果显示,有乙肝家族史(OR=13.052,95%CI:3.799~44.847)的糖尿病患者HBV新发感染的风险增加;规范使用采血/注射装置(OR=0.189,95%CI:0.082~0.436),使用安全锁卡式血糖针(OR=0.142,95%CI:0.073~0.276)、静脉采血针(OR=0.019,95%CI:0.001~0.262)和在家自检血糖(OR=0.466,95%CI:0.222~0.980)的糖尿病患者HBV新发感染的风险降低。
      结论  乙肝家族史是糖尿病患者HBV新发感染风险增加的独立影响因素,在糖尿病患者长期的血糖管理过程中,规范使用采血/注射装置,使用更安全的采血针类型和自检血糖能够降低其发生HBV感染的风险。

     

    Abstract:
      Objective  To analyze the behavioral factors influencing of new hepatitis B virus (HBV) infection in diabetic patients, so as to provide evidence for reducing the risk of new HBV infection in diabetic patients.
      Methods  A nested case-control study was conducted to follow up and observe 4586 diabetic patients. The 114 diabetic patients who newly developed HBV infection during the follow-up period were selected as the case group, and 228 diabetic patients who did not develop HBV infection in the same period were selected as the control group from the cohort population at a matching ratio of 1∶2 according to the age ±2 years. Questionnaire surveys and laboratory examinations were conducted in the cohort. The contents of the questionnaire included family history of hepatitis B, history of trauma, history of receiving/donating blood, individual-related behavioral characteristics, diabetes severity, and behavior related to diabetes treatment and management. In addition, the blood samples of the cohort were tested for hepatitis B surface antigen (HBsAg) by enzyme-linked immunosorbent assay (ELISA). The conditional logistic regression model was used to analyze the related behavioral factors affecting new HBV infection in diabetic patients.
      Results  The median ages of the HBV group and the control group were 64 years old and 66 years old, respectively. There was no statistically significant difference in the composition of sex, age, ethnicity, occupation and amount of formal education between the two groups (P>0.05). Multivariate analysis showed that diabetic patients with a family history of hepatitis B (OR=13.052, 95% CI: 3.799 to 44.847) had a higher risk of new HBV infection, while diabetic patients who used blood collection/injection devices in a standardized way (OR=0.189, 95%CI: 0.082 to 0.436), safety locking blood glucose needles (OR=0.142, 95% CI: 0.073 to 0.276) and venous blood collection needles (OR=0.019, 95% CI: 0.001 to 0.262) and self-testing of blood sugar at home (OR=0.466, 95% CI: 0.222 to 0.980) had a lower risk of new HBV infection.
      Conclusion  Family history of hepatitis B is an independent factor that increases the risk for new HBV infection in diabetic patients. During the process of long-term blood glucose management of diabetic patients, standardized use of blood collection/injection devices, use of safer types of blood sampling lancet, and self-testing of blood glucose help can reduce the risk of HBV infection.

     

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