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Article(id=1241065982718955690, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1241065978004557893, articleNumber=null, orderNo=null, doi=10.20043/j.cnki.MPM.202410248, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1729094400000, receivedDateStr=2024-10-17, revisedDate=null, revisedDateStr=null, acceptedDate=null, acceptedDateStr=null, onlineDate=1773822788170, onlineDateStr=2026-03-18, pubDate=1740412800000, pubDateStr=2025-02-25, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1773822788170, onlineIssueDateStr=2026-03-18, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1773822788170, creator=13701087609, updateTime=1773822788170, updator=13701087609, issue=Issue{id=1241065978004557893, tenantId=1146029695717560320, journalId=1227665162245664772, year='2025', volume='52', issue='4', pageStart='577', pageEnd='768', issueExtLink='null', onlineDate='null', pubDate='null', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=null, createTime=1773822787047, creator=13701087609, updateTime=1773823194927, updator=13701087609, preIssue=null, nextIssue=null, ext={EN=IssueExt(id=1241067688831808347, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1241065978004557893, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1241067688831808348, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1241065978004557893, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null}, startPage=716, endPage=719, ext={EN=ArticleExt(id=1241065983125803199, articleId=1241065982718955690, tenantId=1146029695717560320, journalId=1227665162245664772, language=EN, title=Duplicated reporting of hepatitis B cases in Qinghai, 2018-2022, columnId=1228016573156360233, journalTitle=Modern Preventive Medicine, columnName=Disease Control and Prevention, runingTitle=null, highlight=null, articleAbstract=
Objective

To provide a theoretical basis for improving the monitoring and management of hepatitis B case data in Qinghai by analyzing the duplicate reporting (re-reporting) of hepatitis B cases in Qinghai from 2018 to 2022.

Methods

The data of cases with reported disease type of hepatitis B in Qinghai Province from 2018 to 2022 were collected through the National Notifiable Disease Reporting System (NNDRS), and five types of double-checking rules were set to check hepatitis B cases by using R4.3.2 software , and the restated caseswere further analysedusing χ2 test and Cochran-Armitage trend test.

Results

The cumulative number of repeated reported hepatitis B cases in Qinghai Province from 2018 to 2022 was 6 107 (13.01%), and when the time span of the hepatitis B cases included in the study ranged from 1 to 5 years, the restatement rates were 3.76%, 6.90%, 9.31%, 11.39%, and 13.01%, respectively, and the restatement rate was higher the longer the time span of the included cases (Z=57.931,P<0.001). When the time span of the included cases was 5 years, the restatement rates of the eight cities and states in Qinghai Province ranged from 9.45% to 15.25%, and the restatement rates of acute, chronic, and unclassified hepatitis B cases were 11.79%, 13.06% and 12.58%, respectively.

Conclusion

There is a more serious inter-regional and inter-annual restatement of hepatitis B cases reported in Qinghai Province from 2018-2022, and hepatitis B checking should be strengthened at all levels and in all departments, and targeted measures should be taken to reduce the situation of repeated reporting and improve the monitoring and management of hepatitis B cases.

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目的

分析2018—2022年青海省乙型肝炎（乙肝）病例重复报告（重报）情况，为逐步改善青海省乙肝病例数据监测管理提供理论依据。

方法

通过全国传染病报告信息管理系统（National Notifiable Disease Report System，NNDRS）收集青海省2018—2022年报告病种为乙肝的病例数据，设置5种查重规则，利用R 4.3.2软件对乙肝病例进行查重，并采用χ2检验和Cochran-Armitage趋势检验进一步对重报病例进行分析。

结果

2018—2022 年青海省累计重复报告乙肝病例6 107例（13.01%），纳入研究的乙肝病例时间跨度为1～5个年度时，重报率分别为3.76%、6.90%、9.31%、11.39%、13.01%，纳入病例时间跨度越长重报率越高（Z=57.931,P<0.001）。当纳入病例的时间跨度为5年时，青海省8个市州的重报率在9.45%～15.25%之间，急性、慢性、未分类乙肝病例的重报率分别为11.79%、13.06%和12.58%。

结论

青海省2018—2022年报告的乙肝病例存在较严重的跨地区和跨年度重报，应强化各级各部门的乙肝查重工作，并采取针对性措施以减少重复报告情况、加强乙肝病例监测管理。

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郝增平，E-mail：
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杜星星（1999—），女，硕士在读，研究方向：流行病学与卫生统计学研究

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杜星星（1999—），女，硕士在读，研究方向：流行病学与卫生统计学研究

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杜星星（1999—），女，硕士在读，研究方向：流行病学与卫生统计学研究

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Analysis on duplicate report and deletion of acute hepatitis B related report cards in Tianjin City from 2018 to 2022[J]. Occupation and Health, 2024, 40(15): 2128-2131. (In Chinese), articleTitle=Analysis on duplicate report and deletion of acute hepatitis B related report cards in Tianjin City from 2018 to 2022, refAbstract=null), Reference(id=1241065996082008801, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241065982718955690, doi=null, pmid=null, pmcid=null, year=2023, volume=39, issue=3, pageStart=302, pageEnd=305, url=null, language=null, rfNumber=[14], rfOrder=24, authorNames=王芬, 陈宇, 韩凤情, journalName=医学动物防制, refType=null, unstructuredReference=王芬，陈宇，韩凤情，等．2021年黄冈市医疗机构报告乙肝病例准确性评价研究[J].医学动物防制，2023, 39(3):302-305．, articleTitle=2021年黄冈市医疗机构报告乙肝病例准确性评价研究, refAbstract=null), Reference(id=1241065996216226541, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241065982718955690, doi=null, pmid=null, pmcid=null, year=2023, volume=39, issue=3, pageStart=302, pageEnd=305, url=null, language=null, rfNumber=[14], rfOrder=25, authorNames=Wang F, Chen Y, Han FQ, journalName=Journal of Medical Pest Control, refType=null, unstructuredReference=Wang F, Chen Y, Han FQ, et al. Study on accuracy evaluation of hepatitis B cases reported by medical institutions in Huanggang in 2021[J]. Journal of Medical Pest Control, 2023, 39(3): 302-305. 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Progress in elimination of viral hepatitis as a public health threat in China[J]. Chinese Journal of Viral Diseases, 2023, 13(5): 327-336. (In Chinese), articleTitle=Progress in elimination of viral hepatitis as a public health threat in China, refAbstract=null), Reference(id=1241065996593713931, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241065982718955690, doi=null, pmid=null, pmcid=null, year=2020, volume=47, issue=17, pageStart=3077, pageEnd=3079, 3163, url=null, language=null, rfNumber=[16], rfOrder=28, authorNames=杨国婧, 朱妮, 王舒, journalName=现代预防医学, refType=null, unstructuredReference=杨国婧，朱妮，王舒，等．陕西省2005—2019年乙型病毒性肝炎重复报告情况分析[J].现代预防医学，2020, 47(17):3077-3079, 3163．, articleTitle=陕西省2005—2019年乙型病毒性肝炎重复报告情况分析, refAbstract=null), Reference(id=1241065996723737366, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241065982718955690, doi=null, pmid=null, pmcid=null, year=2020, volume=47, issue=17, pageStart=3077, pageEnd=3079, 3163, url=null, language=null, rfNumber=[16], rfOrder=29, authorNames=Yang GJ, Zhu N, Wang S, journalName=Modern Preventive Medicine, refType=null, unstructuredReference=Yang GJ, Zhu N, Wang S, et al. Hepatitis B duplicate reporting cards in Shaanxi, 2005-2019[J]. Modern Preventive Medicine, 2020, 47(17): 3077-3079, 3163. (In Chinese), articleTitle=Hepatitis B duplicate reporting cards in Shaanxi, 2005-2019, refAbstract=null), Reference(id=1241065996820206364, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241065982718955690, doi=null, pmid=null, pmcid=null, year=2024, volume=51, issue=8, pageStart=1384, pageEnd=1389, url=null, language=null, rfNumber=[17], rfOrder=30, authorNames=苏晓洁, 余擎, journalName=现代预防医学, refType=null, unstructuredReference=苏晓洁，余擎．2011—2021年我国乙型病毒性肝炎流行病学特征及时空聚集性分析[J].现代预防医学，2024, 51(8):1384-1389．, articleTitle=2011—2021年我国乙型病毒性肝炎流行病学特征及时空聚集性分析, refAbstract=null), Reference(id=1241065996954424099, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241065982718955690, doi=null, pmid=null, pmcid=null, year=2024, volume=51, issue=8, pageStart=1384, pageEnd=1389, url=null, language=null, rfNumber=[17], rfOrder=31, authorNames=Su XJ, Yu Q, journalName=Modern Preventive Medicine, refType=null, unstructuredReference=Su XJ, Yu Q. Epidemiological characteristics and spatiotemporal aggregation analyses of hepatitis B virus infection in China, 2011-2021[J]. Modern Preventive Medicine, 2024, 51(8): 1384-1389. (In Chinese), articleTitle=Epidemiological characteristics and spatiotemporal aggregation analyses of hepatitis B virus infection in China, 2011-2021, refAbstract=null)], funds=[Fund(id=1241065991577326070, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241065982718955690, awardId=YGFK2020003, language=CN, fundingSource=中国肝炎基金会—中国乙肝防控科研基金资助课题(YGFK2020003), fundOrder=null, country=null)], companyList=[AuthorCompany(id=1241065983876583665, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241065982718955690, xref=1., ext=[AuthorCompanyExt(id=1241065983880777970, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241065982718955690, companyId=1241065983876583665, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=Department of Public Health, Qinghai University Medical College, Xining, Qinghai 810001, China), AuthorCompanyExt(id=1241065983889166579, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241065982718955690, companyId=1241065983876583665, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=1.青海大学医学院公共卫生系，青海 西宁 810001)]), AuthorCompany(id=1241065983968858362, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241065982718955690, xref=2., ext=[AuthorCompanyExt(id=1241065983973052667, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241065982718955690, companyId=1241065983968858362, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=2.青海省疾病预防控制中心)])], figs=[ArticleFig(id=1241065990574887364, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241065982718955690, language=EN, label=Fig.1, caption=Rate of duplicate reporting of hepatitis B reports by region, 2018-2022, figureFileSmall=XBmpqLsHd+WW9mFQb/ksFA==, figureFileBig=iqhjrzUdKqul5geYLcDP8Q==, tableContent=null), ArticleFig(id=1241065990662967753, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241065982718955690, language=CN, label=图1, caption=2018—2022年不同地区乙肝报告重复报告率, figureFileSmall=XBmpqLsHd+WW9mFQb/ksFA==, figureFileBig=iqhjrzUdKqul5geYLcDP8Q==, tableContent=null), ArticleFig(id=1241065990885265873, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241065982718955690, language=EN, label=Table 1, caption=

Repeated reports of hepatitis B cases in different years from 2018 to 2022

, figureFileSmall=null, figureFileBig=null, tableContent=
时间跨度（年）纳入病例数重复报告病例数重复报告率（%）
201810 1694184.11
201910 3104394.26
20209 8143693.76
20219 6043433.57
20227 0542193.10
2018—201920 4791 5807.72
2019—202020 1241 4257.08
2020—202119 4181 2876.63
2021—202216 6581 0296.18
2018—202030 2932 9819.84
2019—202129 7282 8319.52
2020—202226 4722 2708.58
2018—202139 8974 66411.69
2019—202236 7824 07711.08
2018—202246 9516 10713.01
), ArticleFig(id=1241065990985929174, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241065982718955690, language=CN, label=表1, caption=

2018—2022年乙肝病例不同年份的重复报告情况

, figureFileSmall=null, figureFileBig=null, tableContent=
时间跨度（年）纳入病例数重复报告病例数重复报告率（%）
201810 1694184.11
201910 3104394.26
20209 8143693.76
20219 6043433.57
20227 0542193.10
2018—201920 4791 5807.72
2019—202020 1241 4257.08
2020—202119 4181 2876.63
2021—202216 6581 0296.18
2018—202030 2932 9819.84
2019—202129 7282 8319.52
2020—202226 4722 2708.58
2018—202139 8974 66411.69
2019—202236 7824 07711.08
2018—202246 9516 10713.01
), ArticleFig(id=1241065991103369692, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241065982718955690, language=EN, label=Table 2, caption=

Reporting of cumulative hepatitis B cases from 2018 to 2022

, figureFileSmall=null, figureFileBig=null, tableContent=
年份纳入病例纳入病例中的重报病例
急性慢性未分类合计
急性慢性未分类合计重报例数重报率(%)重报例数重报率(%)重报例数重报率(%)重报例数重报率(%)
20181799 21677410 169147.823673.98374.784184.11
20191399 36880310 31075.041 06811.408710.831 16211.27
2020809 0376979 8141721.251 28514.229914.201 40114.28
2021938 6428699 6041010.751 53617.7713715.771 68317.52
2022866 3686007 0542023.261 31220.6011118.501 44320.46
合计5774 26313 74346 9516811.795 56813.0647112.58610713.01
), ArticleFig(id=1241065991216615905, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241065982718955690, language=CN, label=表2, caption=

2018—2022年累计乙肝病例重报情况

, figureFileSmall=null, figureFileBig=null, tableContent=
年份纳入病例纳入病例中的重报病例
急性慢性未分类合计
急性慢性未分类合计重报例数重报率(%)重报例数重报率(%)重报例数重报率(%)重报例数重报率(%)
20181799 21677410 169147.823673.98374.784184.11
20191399 36880310 31075.041 06811.408710.831 16211.27
2020809 0376979 8141721.251 28514.229914.201 40114.28
2021938 6428699 6041010.751 53617.7713715.771 68317.52
2022866 3686007 0542023.261 31220.6011118.501 44320.46
合计5774 26313 74346 9516811.795 56813.0647112.58610713.01
), ArticleFig(id=1241065991334056423, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241065982718955690, language=EN, label=Table 3, caption=

The situation of different regions in 2018-2022 is rereported

, figureFileSmall=null, figureFileBig=null, tableContent=
地区纳入病例数重复报告数重复报告率（%）χ2P值
西宁市3 43914 50213.09
海东市3 25644913.79
海北藏族自治州84111013.08
黄南藏族自治州2 15024211.2635.916P<0.001
海南藏族自治州2 23634115.25
果洛藏族自治州1 87823712.62
玉树藏族自治州1 5871509.45
海西蒙古族藏族自治州6127612.42
合计46 9516 10713.01
), ArticleFig(id=1241065991464079856, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241065982718955690, language=CN, label=表3, caption=

2018—2022年不同地区重报情况

, figureFileSmall=null, figureFileBig=null, tableContent=
地区纳入病例数重复报告数重复报告率（%）χ2P值
西宁市3 43914 50213.09
海东市3 25644913.79
海北藏族自治州84111013.08
黄南藏族自治州2 15024211.2635.916P<0.001
海南藏族自治州2 23634115.25
果洛藏族自治州1 87823712.62
玉树藏族自治州1 5871509.45
海西蒙古族藏族自治州6127612.42
合计46 9516 10713.01
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2018—2022年青海省乙型肝炎病例重复报告分析
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杜星星 1, 2 , 郝增平 1, 2 , 阿克忠 2 , 巴文生 2 , 关炳菊 2 , 李孟旸 2 , 马强 2 , 郭子哲 1 , 徐瑾 1
现代预防医学 | 疾病预防控制 2025,52(4): 716-719
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现代预防医学 | 疾病预防控制 2025, 52(4): 716-719
2018—2022年青海省乙型肝炎病例重复报告分析
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杜星星1, 2, 郝增平1, 2 , 阿克忠2, 巴文生2, 关炳菊2, 李孟旸2, 马强2, 郭子哲1, 徐瑾1
作者信息
  • 1.青海大学医学院公共卫生系，青海 西宁 810001
  • 2.青海省疾病预防控制中心

    • 杜星星（1999—），女，硕士在读，研究方向：流行病学与卫生统计学研究

通讯作者:

郝增平，E-mail：
Duplicated reporting of hepatitis B cases in Qinghai, 2018-2022
Xing-xing DU1, 2, Zeng-ping HAO1, 2 , Ke-zhong A2, Wen-sheng BA2, Bing-ju GUAN2, Meng-yang LI2, Qiang MA2, Zi-zhe GUO1, Jin XU1
Affiliations
  • Department of Public Health, Qinghai University Medical College, Xining, Qinghai 810001, China
出版时间: 2025-02-25 doi: 10.20043/j.cnki.MPM.202410248
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摘要
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目的

分析2018—2022年青海省乙型肝炎（乙肝）病例重复报告（重报）情况，为逐步改善青海省乙肝病例数据监测管理提供理论依据。

方法

通过全国传染病报告信息管理系统（National Notifiable Disease Report System，NNDRS）收集青海省2018—2022年报告病种为乙肝的病例数据，设置5种查重规则，利用R 4.3.2软件对乙肝病例进行查重，并采用χ2检验和Cochran-Armitage趋势检验进一步对重报病例进行分析。

结果

2018—2022 年青海省累计重复报告乙肝病例6 107例（13.01%），纳入研究的乙肝病例时间跨度为1～5个年度时，重报率分别为3.76%、6.90%、9.31%、11.39%、13.01%，纳入病例时间跨度越长重报率越高（Z=57.931,P<0.001）。当纳入病例的时间跨度为5年时，青海省8个市州的重报率在9.45%～15.25%之间，急性、慢性、未分类乙肝病例的重报率分别为11.79%、13.06%和12.58%。

结论

青海省2018—2022年报告的乙肝病例存在较严重的跨地区和跨年度重报，应强化各级各部门的乙肝查重工作，并采取针对性措施以减少重复报告情况、加强乙肝病例监测管理。

乙型肝炎  /  重复报告  /  发病率  /  报告系统
Objective

To provide a theoretical basis for improving the monitoring and management of hepatitis B case data in Qinghai by analyzing the duplicate reporting (re-reporting) of hepatitis B cases in Qinghai from 2018 to 2022.

Methods

The data of cases with reported disease type of hepatitis B in Qinghai Province from 2018 to 2022 were collected through the National Notifiable Disease Reporting System (NNDRS), and five types of double-checking rules were set to check hepatitis B cases by using R4.3.2 software , and the restated caseswere further analysedusing χ2 test and Cochran-Armitage trend test.

Results

The cumulative number of repeated reported hepatitis B cases in Qinghai Province from 2018 to 2022 was 6 107 (13.01%), and when the time span of the hepatitis B cases included in the study ranged from 1 to 5 years, the restatement rates were 3.76%, 6.90%, 9.31%, 11.39%, and 13.01%, respectively, and the restatement rate was higher the longer the time span of the included cases (Z=57.931,P<0.001). When the time span of the included cases was 5 years, the restatement rates of the eight cities and states in Qinghai Province ranged from 9.45% to 15.25%, and the restatement rates of acute, chronic, and unclassified hepatitis B cases were 11.79%, 13.06% and 12.58%, respectively.

Conclusion

There is a more serious inter-regional and inter-annual restatement of hepatitis B cases reported in Qinghai Province from 2018-2022, and hepatitis B checking should be strengthened at all levels and in all departments, and targeted measures should be taken to reduce the situation of repeated reporting and improve the monitoring and management of hepatitis B cases.

Hepatitis B  /  Repeat reporting  /  Incidence  /  Reporting system
杜星星, 郝增平, 阿克忠, 巴文生, 关炳菊, 李孟旸, 马强, 郭子哲, 徐瑾. 2018—2022年青海省乙型肝炎病例重复报告分析. 现代预防医学, 2025 , 52 (4) : 716 -719 . DOI: 10.20043/j.cnki.MPM.202410248
Xing-xing DU, Zeng-ping HAO, Ke-zhong A, Wen-sheng BA, Bing-ju GUAN, Meng-yang LI, Qiang MA, Zi-zhe GUO, Jin XU. Duplicated reporting of hepatitis B cases in Qinghai, 2018-2022[J]. Modern Preventive Medicine, 2025 , 52 (4) : 716 -719 . DOI: 10.20043/j.cnki.MPM.202410248
正文
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乙肝是由乙肝病毒（Hepatitis B Virus, HBV）引起的一种传染性疾病，由于乙肝治疗病程较长且病情迁延，乙肝患者可能跨地区多次反复就诊，造成乙肝病例报告的准确性不高[1-3]。研究表明，现有的国家法定传染病报告系统中的乙肝病例存在重复报告，报告发病率不能反映实际发病水平[4-6]。青海省的乙肝报告发病率远高于全国平均报告发病率[7]，为评估网报数据是否能反映青海省乙肝真实发病水平，准确掌握青海省乙肝的发病率，本研究通过运用查重软件分析青海省2018—2022年乙肝病例重复报告情况，科学评价青海省的乙肝报告情况。以期提高青海省乙肝监测数据的质量，为青海省乙肝病例数据监测管理提供科学依据。
1　材料与方法
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1.1　数据来源
通过全国传染病报告信息管理系统（NNDRS）收集青海省2018年1月1日至2022年12月31日报告病种为乙肝的全部病例，包括临床诊断病例、实验室确诊病例、疑似病例和病原携带者。
1.2　研究方法
1.2.1　重复报告判断规则
对整理后的乙肝病例数据库设定5种查重规则进行查重:（A）身份证号码信息相同；（B）出生日期、性别、姓名相同；（C）出生日期、姓名、现住地址标码前六位相同；（D）出生日期、性别、现住详细地址相同；（E）姓名、联系电话、现住地址标码前六位相同。
1.2.2　重复报告次数统计
对判定为重报的数据进行唯一标识编码，进而计算重报次数，编码方法:首先对按照5种规则筛选出的五年内重报的病例进行顺序编码（病例ID：1，2，3，…，N），然后任意选取一条病例按照5种查重规则与剩余病例进行逐一比对，使用规则A—E对数据进行编码更新，最后在判定为重报病例的一组数据集合中，将其编码统一赋值为最小编码，例如按照规则（A）身份证号相同的3条数据编码为1～3，将其编码统一赋值为1，重复报告次数记为3次。
1.3　统计分析
采用Excel 2020软件建立和整理乙肝病例病例数据库，使用R 4.3.2软件实现数据库查重和重复次数统计，计数资料采用χ2检验进行率的比较，变化趋势采用Cochran-Armitage趋势检验，双侧检验水准α=0.05。重报率（%）=（重报病例数/纳入病例总数）×100%。
2　结果
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2.1　青海省2018—2022年乙肝报告情况
2018—2022年青海省共报告乙肝病例47 093例，包括临床诊断病例1 441例、实验室确诊病例45 510例、疑似病例54例和病原携带者88例。其中急性、慢性和未分类乙肝病例分别占报告病例总数的1.23%（578例）、90.79%（42 757例）和7.98%（3 758例）。2018—2022年青海省乙肝报告发病率分别为155.54/10万、160.64/10万、150.99/10万、154.47/10万和116.02/10万，年均报告发病率为147.60/10万。
2.2　本文纳入的乙肝报告病例基本情况
本研究仅纳入已终审的临床诊断病例和实验室确诊病例，共46 951例。完整填写18位身份证号的病例46 053例（98.09%）；完整填写11位联系电话的病例42 815例（91.19%）；其余5项查重指标填写率均为100%。
2.3　本文纳入的乙肝病例重复报告情况
2.3.1　不同年份乙肝病例重复报告情况
2018—2022年青海省累计重复报告乙肝病例数为6 107例，年度内重报数为1 788例，跨年度重报数为4 319例，2018—2022年各年度内重报率分别为4.11%、4.26%、3.76%、3.57%和3.10%，年度内重报率总体呈逐年下降趋势（Z=-4.054，P<0.001）。2018—2022年青海省乙肝报告跨1年、2年、3年、4年和5年的累计重报率分别为3.76%、6.90%、9.31%、11.39%和13.01%，跨年度重报率总体呈逐年上升趋势（Z=57.931，P<0.001）。见表1。
2.3.2　不同类型乙肝病例重复报告情况
本研究纳入的46 951例乙肝病例中，急性乙肝病例577例，其中11.79%（68例）为重报病例，急性乙肝重报率总体呈逐年上升趋势（Z=3.793，P<0.001）；慢性乙肝病例42 631例，其中13.06%（5 568例）为重报病例；未分类乙肝病例3 743例，其中12.58%（471例）为重报病例，见表2。
2.3.3　不同地区乙肝病例重复报告情况
2018—2022年青海省8个市州均存在乙肝病例重复报告，各市州重报率差异有统计学意义（χ2=35.916，P<0.001），其中海南藏族自治州的重复报告率最高，为15.25%，见表3。五年间8个市州各年重复报告数占当年乙肝报告总数的比例如图1所示。
2.3.4　重复报告次数统计
2018—2022年报告的46 951例乙肝病例中，有6 107例乙肝病例被报告2次及以上，其中4 411例（72.23%）被报告2次；677例（22.17%）被报告3次；88例（4.32%）被报告4次；17例（1.12%）被报告5次；2例（0.16%）被报告6次。
3　讨论
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青海省2018—2022年乙肝年均报告发病率为147.60/10万，虽然近几年青海省乙肝报告发病率呈下降趋势，但相较于全国平均水平，青海省乙肝报告发病率仍处于较高水平。乙肝病例重报一定程度上会影响乙肝报告发病率的准确性，本研究显示，2018—2022年青海省报告的46 951例乙肝病例中，累计重报率为13.01%，去除重复病例后，乙肝年均发病率降低为127.21/10万，较调整前乙肝年均报告发病率下降了13.8%。
青海省2018—2022年各年度内重报率总体呈逐年下降趋势，但跨年度累计重报率呈上升趋势，且纳入病例时间跨度越长重报率越高，与2016—2020年福建省乙肝重报变化趋势基本一致[8]。且青海省乙肝重复报告以跨年度重复报告为主，胡改霞等学者研究的陕西省乙肝重复报告也以跨年度重复报告为主[9]。重复报告以跨年度重报为主，可能是由于全国传染病信息报告管理系统虽明确了重报病例的判定条件，但未在传染病监测模块中配置跨年度查重功能，因而导致乙肝重报以跨年度重报为主。青海省慢性乙肝的重报率高于未分类和急性乙肝重报率，主要是由于慢性乙肝患者居多，且病程较长迁延不愈导致反复多次就诊[10]。但青海省急性乙肝的重报率仍较高，推测部分临床医生将慢性乙肝的急性发病期患者作为急性乙肝病例进行网络直报，但实际情况还有待于进一步证实。
青海省8个市州均存在乙肝重报，且各市州的乙肝重报率均较高，查重过程中发现乙肝病例的重复报告主要是因为患者多次异地就诊造成的，可能是由于青海省医疗资源分布不均，导致乙肝患者进行跨地区、跨机构的就诊概率增加，从而增加重复报告的概率[11]。将跨地区复诊乙肝病例作为初诊病例进行网络直报，提示青海省乙肝病例报告信息系统需要进一步管理规范。根据传染病信息报告管理规范要求，县级疾病预防控制机构及具备网络直报条件的医疗机构应每日对报告信息进行查重，对重复报告病例进行删除。为解决跨年度和跨地区的乙肝重报病例，建议青海省各级卫生部门加强对乙肝病例报告人员的培训，各级疾病预防控制机构对乙肝报告信息开展定期查重工作，加强乙肝病例报告信息的科学管理和实时监测。
对重复报告病例进行重报次数统计时发现重复报告１次的情况最为常见，仍存在部分身份证号为空或者身份证号位数不正确的乙肝病例，建议在填写乙肝电子报告病例时对严格设置身份证号填写格式和规则。研究表明目前医院等传染病报告单位尚未将就诊患者实名制作为强制要求，乙肝就诊患者实际身份证号和医院登记的身份证号可能并不相同，表明用身份证号进行查重仍具有一定的局限性，需要进一步完善网络报告和信息管理体系[12-13]。建议国家完善NNDRS中跨年度、跨地区等方面的乙肝病例查重功能，青海省加强辖区报告的乙肝病例查重工作，及时删除重复报告病例，对乙肝病例进行规范化的管理和报告，以提高乙肝病例报告的准确性，进一步提高乙肝监测数据质量[14-15]。为促进更好地“实现2030消除病毒性肝炎”行动计划，青海省应积极探索乙肝病例信息报告管理新模式，在重视乙肝病例漏报的同时应提高病例报告信息的准确性，建议卫生行政部门将乙肝等慢性传染病的准确率、漏报率和重复报告率均作为传染病信息报告管理考核指标，从源头减少误报和重报，加强青海省的乙肝监测和防治资源配置[16-17]。
基金
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  • 中国肝炎基金会—中国乙肝防控科研基金资助课题(YGFK2020003)
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参考文献 引证文献
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2025年第52卷第4期
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doi: 10.20043/j.cnki.MPM.202410248
  • 接收时间：2024-10-17
  • 首发时间：2026-03-18
  • 出版时间：2025-02-25
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  • 收稿日期：2024-10-17
基金
中国肝炎基金会—中国乙肝防控科研基金资助课题(YGFK2020003)
作者信息
    1.青海大学医学院公共卫生系，青海 西宁 810001
    2.青海省疾病预防控制中心

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2种不同金属材料的力学参数
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Family		 属数
Number of
genus		 种数
Number of
species		 占总种数比例
Percentage of
total species (%)		 属
Genus		 种数
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species		 占总种数比例
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鹅膏菌科Amanitaceae 2 11 5.26 鹅膏菌属 Amanita 10 4.78
小菇科 Mycenaceae 2 12 5.74 丝盖伞属 Inocybe 5 2.39
多孔菌科 Polyporaceae 8 14 6.70 蜡蘑属 Laccaria 5 2.39
红菇科 Russulaceae 3 23 11.00 小皮伞属 Marasmius 6 2.87
小菇属 Mycena 11 5.26
光柄菇属 Pluteus 5 2.39
红菇属 Russula 17 8.13
栓菌属 Trametes 5 2.39
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