目的 了解绵阳市农村居民乙肝表面抗原（HBsAg）阳性、HBsAg和乙肝表面抗体（HBsAb）双阴分布的现况，为制定农村乙肝防控策略提供科学依据。方法 采取多阶段随机抽样方法抽取163 797名农村居民作为调查对象，对其进行一对一问卷调查，并采取血标本，采用酶联免疫吸附试验（ELISA）对分离出的血清进行HBsAg和HBsAb检测，分析其表达分布的流行病学特征。结果 调查对象HBsAg总阳性率为6.57%〔95%可信区间（CI）:6.45%～6.69%〕，双阴率为40.32%（95%CI:40.36%～40.84%）。男性HBsAg阳性率（7.74%）高于女性（5.73%），双阴率（39.93%）低于女性（40.61%）；56～65岁人群HBsAg阳性率（7.36%）最高，86～96岁人群双阴率（47.61%）最高；已婚人群HBsAg阳性率（6.63%）高于未婚人群（5.54%）和离异/丧偶人群（6.11%），离异/丧偶人群的双阴率（43.04%）最高；涪城区HBsAg阳性率（9.23%）高于江油市（5.38%）和安县（5.77%），安县双阴率（55.24%）最高；有乙肝家族史人群的HBsAg阳性率（21.01%）高于无乙肝家族史人群（6.41%），双阴率（30.10%）低于后者（40.60%）；有乙肝疫苗接种史人群的HBsAg阳性率（3.78%）和双阴率（37.91%）均低于无乙肝疫苗接种史人群（分别为7.30%和40.92%）；上述差异均有统计学意义（P<0.05）。结论 绵阳市农村居民HBsAg阳性率和双阴率均较高，高龄、未接种乙肝疫苗者应重点防控。Objective To determine the prevalence of positive HBsAg and negative HBsAg populations in rural Mianyang, and provide evidence support for proper immunization strategies. Methods A questionnaire survey was conducted on 163 797 rural residents in Mianyang selected through a multistage random sampling strategy. Serum samples were taken from the participants to detect HBsAg and HBsAb with enzyme-linked immunosorbent assay (ELISA). Results Overall, 6.57% 〔95% confidence interval (CI): 6.45%-6.69%〕 of participants were HBsAg positive. In those with negative HBsAg, 40.32% (95%CI: 40.36%-40.84%) had negative HBsAb. Higher prevalence of positive HBsAg was found in the male participants (7.74%) compared with the females (5.73%). But the male participants with negative HBsAg were less likely to have negative HBsAb (39.93%) than their female counterparts (40.61%). Those aged between 56 and 65 years had the highest prevalence of positive HBsAg (7.36%); whereas, those aged between 86 and 96 years had the highest prevalence of negative HBsAg/HBsAb (47.61%). The participants who were married (6.63%), resided in Fucheng District (9.23%), had a family history of Hepatitis B (21.01%) and were not vaccinated (7.30%) had higher prevalence of positive HBsAg than others. Those who were divorced and widowed (43.04%), resided in An County (55.24%), had no family history of Hepatitis B (40.60%), and were vaccinated (40.92%) had higher prevalence of negative HBsAg/HBsAb than others. These differences were statistically significant (P<0.05). Conclusion A high proportion of ruralresidents in Mianyang are HBsAg positive or HBsAg/HBsAb negative. The older population and those without ]vaccination should be the main target in the prevention and control of hepatitis B.