目的掌握自然人群慢性HBV感染者临床诊断分型及乙型肝炎病毒脱氧核糖核酸(HBV-DNA)、丙氨酸氨基转移酶(ALT)分布特征,为实施干预提供科学依据。方法 2012年对寿光市自然人群HBV感染基线调查发现的乙肝表面抗原阳性者进行体检,依据血清学、临床、B超、病史等检查结果进行临床诊断。结果 1 902例感染者,临床诊断分型为携带者占66.72%、慢性乙肝占31.81%、肝硬化占0.94%、疑似肝癌占0.53%,临床分型与性别有关,差异有统计学意义(P<0.01);HBV-DNA>500拷贝/ml的阳性率为55.15%,ALT>40u/L的异常率为25.87%,两项指标男性均高于女性(P<0.01),且年龄分布也存在明显差异(P<0.01);感染者适应抗病毒治疗率为30.65%。结论自然人群中慢性HBV感染者以携带者为主,部分感染者HBV-DNA、ALT水平较高,适应抗病毒治疗。 Objective To understand the clinical diagnostic typing and the distribution of hepatitis B virus (HBV) DNA and alanine aminotransferase (ALT) in patients with chronic HBV infection in the natural population and provide a scientific basis for the intervention. Methods In 2012, HBsAg positive patients who were found by HBV infection in the natural population of Shouguang City were examined by serology, clinical, B-ultrasound and medical history. Results 1 902 cases of infection were clinically diagnosed as carriers, accounting for 66.72%, chronic hepatitis B accounting for 31.81%, cirrhosis accounting for 0.94%, accounting for 0.53% of suspected liver cancer, clinical classification and gender, the difference was statistically significant (P <0.01). The positive rate of HBV-DNA> 500 copies / ml was 55.15%, and the abnormal rate of ALT> 40u / L was 25.87%. Both indicators were higher in males than in females (P <0.01) (P <0.01). The rate of antiviral treatment for those infected was 30.65%. CONCLUSION: Chronic HBV infection in the natural population is predominant in carriers. HBV-DNA and ALT levels are higher in partially infected patients and are suitable for antiviral therapy.