【摘要】 目的 评估甲型肝炎（简称甲肝）疫苗（hepatitis A vaccine, HepA）试点（1996年）以及2008年被纳入国家扩大免疫规划（expanded program on immunization, EPI）前后，对上海市甲肝发病率的影响，为上海市甲肝的防控效果评价提供科学依据。方法 利用国家人口健康科学数据中心和《中国卫生年鉴》获取甲肝报告发病资料（1990—2019年）,选中断时间序列（interrupted time series, ITS）方法构建中断线性回归模型，模拟HepA试点和HepA纳入EPI前后甲肝的发病率水平和斜率改变情况，利用t检验行模型系数检验、灰色模型（grey model, GM）拟合2008年后甲肝的发病数据，采用Mantel-Haenszel χ²检验行甲肝发病率线性趋势分析。结果 1990—2019年上海市甲肝年均发病率为5.24/10万，发病率呈线性下降趋势(χ_趋势²=17.92,P<0.001)。HepA试点前发病率为13.95/10万，下降斜率为3.21/10万，试点后发病率为4.95/10万，下降斜率为0.26/10万。HepA纳入EPI前发病率为8.22/10万，下降斜率为1.22/10万，纳入EPI后发病率为4.13/10万，斜率为0.25/10万。结论 甲肝发病率在HepA试点后呈下降趋势，HepA纳入EPI后甲肝发病率虽有小范围波动，但平均发病率较HepA纳入EPI前低，整体上甲肝发病率维持在较低水平，HepA试点和HepA纳入EPI对降低上海市甲肝发病率发挥重要作用。更多还原

【Abstract】 Objective To evaluate the impact of the hepatitis A vaccine（HepA） pilot program（1996） and included in the national expanded program on immunization（EPI） in 2008 on the incidence rate of hepatitis A in Shanghai City, and to provide a scientific basis for the evaluation of the effectiveness of prevention and control of hepatitis A in Shanghai City.Methods The data on reported incidence rate of hepatitis A（1990-2019） were obtained from the national population health science data center and the Chinese Health Yearbook.The interrupted time series（ITS） method was selected to construct an interrupted linear regression model to simulate the change in the level and slope of incidence rate of hepatitis A before and after the HepA pilot and the inclusion of HepA in EPI.The t test was used to test the model coefficient test.The gray model（GM） was used to fit the incidence data of hepatitis A after 2008.The Mantel-Haenszel χ² test was used to analyze the linear trend of incidence rate of hepatitis A.Results From 1990 to 2019,the annual average incidence rate of hepatitis A was 5.24/100 000 in Shanghai City, with a linear decreasing trend in the incidence rate(χ_trend²=17.92,P<0.001).The incidence rate was 13.95/100 000 before the HepA pilot with a decline slope of 3.21/100 000.The incidence rate was 4.95/100 000 after the HepA pilot with a decline slope of 0.26/100 000.The incidence rate of was 8.22/100 000 with a decline slope of 1.22/100 000 before the inclusion of HepA in EPI.The incidence rate was 4.13/100 000 with a slope of 0.25/100 000 after inclusion in the EPI.Conclusion The incidence rate of hepatitis A shows a decreasing trend after the HepA pilot.Although the incidence rate of hepatitis A fluctuated in a small range after the inclusion of HepA in EPI,the average incidence rate is lower than that before the inclusion of HepA in EPI.The overall incidence rate of hepatitis A remains at a low level.The HepA pilot and the inclusion of HepA in EPI plays an important role in reducing the incidence rate of hepatitis A in Shanghai City.更多还原