丙型肝炎病毒感染与2型糖尿病发病关系的病例对照研究

发布时间：2018-05-02 13:10

本文选题：丙型肝炎 + 丙型肝炎病毒抗体　；参考：《广西医科大学》2013年硕士论文

【摘要】：目的糖尿病是我国常见的慢性代谢性疾病之一,其病程长,并发症多,严重影响人们的身体健康和生活质量。本研究通过调查2型糖尿病患者中丙型肝炎病毒抗体(抗-HCV)的流行情况及丙型肝炎病毒基因型的分布情况,探索丙型肝炎感染是否为2型糖尿病发病的危险因素以及2型糖尿病发病是否与丙型肝炎病毒的基因分型有关,为今后糖尿病的防治提供科学依据。方法1、2012年3月-5月,从广西医科大学第一附属医院收集2型糖尿病者710例,同期在该院收集对照者696例。采用统一的问卷对纳入研究者进行相关方面的资料收集,同时对所有纳入研究的对象使用一次性采血针及真空管采集静脉血5mL,将血样以3000r/min离心10分钟后分离血清,取上清,血清标本存放-80℃冰箱备检。 2、采用酶联免疫法对2型糖尿病者和对照者的血清进行抗-HCV检测和乙肝病毒表面抗原(HBsAg)检测,并将两者的阳性率及性别分层进行比较。 3、用相关试剂对抗-HCV呈阳性的血清标本进行病毒RNA的提取,逆转录成cDNA,然后用巢式PCR的方法进行HCV RNA的检测。 4、将PCR产物送检测,根据每个样本的测序结果用Blast软件比对分析序列,确保基因分型的准确性,进行HCV基因分型。 5、对所有数据进行录入,建立数据库,采用SPSS13.0分析软件进行数据处理,率的比较用χ2检验,两组均数的比较用t检验,以P0.05为差异有统计学意义。结果1、2型糖尿病患者与对照者性别、年龄均数和乙型肝炎感染方面均衡可比。2型糖尿病患者组710例,男383例,女327例。对照组696例,其中男384例,女312例。两组之间性别构成差异无统计学意义(χ2=0.214,P0.05)。两组年龄均数差异无统计学意义(t=1.277,P0.05)。两组乙型肝炎表面抗原阳性率差异无统计学意义(χ2=0.764,P0.05)。 2、2型糖尿病组的抗-HCV阳性率(3.10%)明显高于对照组的阳性率(1.29%),两者的差异有统计学意义(χ2=5.313,P0.05)。但在所有年龄组中,只有60-69岁年龄组中两者的差异有统计学意义(χ2=6.891,P0.01),其他年龄组差异无统计学意义。 3、2型糖尿病组与对照组之间比值比(OR)为2.44,表明HCV感染将使2型糖尿病发病危险性增加2.44倍左右(95%可信区间为1.14-5.21)。 4、病例组22例抗-HCV阳性者中,男11例,女11例。对照组9例抗-HCV阳性者中,男4例,女5例,采用逆转录巢式PCR对这31例样本进行检测,HCV RNA呈阳性24例,占77.42%(24/31),其中病例组的为19例,占86.36%(19/22)。对照组5例,占55.56%(5/9),两者差异无统计学意义(P0.05)。 5、根据序列比对结果,我们得出24例HCV RNA阳性的标本中,1b型21例,占87.5%(21/24)。2a型3例,占12.5%(3/24),未见混合型。本研究中,病例组HCV RNA阳性19例,其中1b型16例,2a型3例。对照组中,HCV RNA阳性5例,其中1b型5例,未检出2a型。 6、在24例HCV基因分型中,2型糖尿病组19例,其中lb型16例,1b型阳性率为2.25%(16/710)。2a型3例,2a型阳性率为0.42%(3/710)。对照组5例,其全部为lb型,阳性率为0.72%(5/696)。糖尿病组1b型的阳性率与对照组阳性率差异有统计学意义(χ2=5.630,P0.05)。在各年龄段病例组与对照组1b基因型阳性率比较中,60-69岁年龄段两者差异有统计学意义(χ2=4.503,P0.05),其他年龄段差异无统计学意义(P0.05)。结论1、2型糖尿病患者丙型肝炎病毒的感染率高于普通人群,乙型肝炎病毒表面抗原阳性率与普通人群无差异,提示丙型肝炎病毒感染可能是2型糖尿病发病的危险因子。 2、根据丙型肝炎病毒的基因分型结果,广西地区HCV流行主要为1b型和2a型。 3、糖尿病患者中1b型的阳性率高于普通人群,尤其是60-69岁年龄段风险最高。推测可能HCV1b型更容易合并糖尿病的发生。
[Abstract]:Objective diabetes is one of the common chronic metabolic diseases in China. It has a long course and many complications, which seriously affect the health and quality of life of the people. In this study, the prevalence of hepatitis C virus antibody (anti -HCV) and the distribution of hepatitis C virus genotype in type 2 diabetes patients were investigated and the infection of hepatitis C infection was explored. Whether or not the risk factors for the onset of type 2 diabetes and whether the onset of type 2 diabetes is related to the genotyping of HCV, provides a scientific basis for the prevention and treatment of diabetes in the future.
Methods 710 cases of type 2 diabetes were collected from the First Affiliated Hospital of Guangxi Medical University in March 12012. 696 cases of control were collected at the same period in the same period. A unified questionnaire was used to collect data on the related subjects. At the same time, all the subjects were collected with a single blood collection needle and vacuum tube to collect the venous blood 5mL. Blood samples were centrifuged for 10 minutes after 3000r/min centrifugation. Serum samples were collected from Torikami Kiyo. Serum samples were stored at -80 C refrigerator for preparation.
2, anti -HCV detection and hepatitis B virus surface antigen (HBsAg) were detected by enzyme linked immunosorbent assay (ELISA) in the serum of type 2 diabetes and control, and the positive rate and gender stratification were compared.
3, using related reagents to extract RNA from -HCV positive serum samples, reverse transcription into cDNA, and then detect HCV RNA by nested PCR.
4, the PCR products were sent to the test. According to the sequencing results of each sample, the sequence of Blast software was used to compare and analyze the sequence, so as to ensure the accuracy of genotyping and HCV genotyping.
5, all the data were recorded, the database was established, and the SPSS13.0 analysis software was used to process the data. The ratio of the rate was compared with the x 2 test. The comparison of the average number of the two groups was tested by T, and the difference was statistically significant with the difference of P0.05.
Results the balance of sex, age and hepatitis B infection in type 1,2 diabetes patients was 710 cases of type.2 diabetes, 383 men and 327 women. 696 cases in the control group, including 384 men and 312 women. There was no statistical difference between the two groups (x 2= 0.214, P0.05). There was no statistical difference between the two groups (t 0.214, P0.05). =1.277, P0.05). There was no significant difference in the positive rate of HBsAg between the two groups (chi 2=0.764, P0.05).
The positive rate of anti -HCV in type 2,2 diabetes group (3.10%) was significantly higher than that of the control group (1.29%). The difference between the two groups was statistically significant (x 2=5.313, P0.05). But in all age groups, the difference between the two groups was statistically significant (x 2=6.891, P0.01), and there was no statistical difference in the other age groups.
The ratio Ratio (OR) between the type 3,2 diabetes group and the control group was 2.44, indicating that HCV infection would increase the risk of type 2 diabetes by 2.44 times (95% confidence interval 1.14-5.21).
4, among the 22 cases of anti -HCV positive cases in the case group, 11 cases were male and 11 women. 9 cases of anti -HCV positive in the control group, 4 men and 5 women, the 31 samples were detected by the reverse transcription nested PCR, and HCV RNA was positive in 24 cases, accounting for 77.42% (24/31), including 19 cases in the case group, accounting for 86.36% (19/22). The control group was 9 (5/9). The difference was not statistically significant. (P0.05).
5, according to the sequence alignment results, we obtained 24 cases of HCV RNA positive, 21 cases of 1B type, 87.5% (21/24).2a type 3 cases, 12.5% (3/24), no mixed type. In this study, 19 cases of HCV RNA positive in the case group, 1b type 16, 2A type 3, 5 cases of HCV RNA, 5 cases, not detected type.
6, in 24 cases of HCV genotyping, 19 cases of type 2 diabetes, of which 16 cases were lb, 3 cases of type 1b positive, 2.25% (16/710).2a, 2 a positive rate was 0.42% (3/710). 5 cases in the control group were LB type, the positive rate was 0.72% (5/696). The difference between the positive rate of the 1b type in the diabetic group and the control group was statistically significant (x 2=5.630, P0.05). In every year, the positive rate was statistically significant (x 2=5.630, P0.05). The difference in the positive rate of 1B genotype between the age group and the control group was statistically significant (x 2=4.503, P0.05), and there was no significant difference in the other age groups (P0.05) in the age group of the age group and the control group.
Conclusion the infection rate of hepatitis C virus in patients with type 1,2 diabetes is higher than that of the general population. There is no difference between the positive rate of HBsAg and the general population, suggesting that HCV infection may be a risk factor for the onset of type 2 diabetes.
2, according to the genotype of HCV, the prevalence of HCV in Guangxi is mainly 1b and 2A.
3, the positive rate of type 1B in diabetic patients is higher than that in the general population, especially in the 60-69 year old age group. It is speculated that HCV1 B is more likely to be associated with diabetes mellitus.

【学位授予单位】：广西医科大学
【学位级别】：硕士
【学位授予年份】：2013
【分类号】：R512.63;R587.1

【参考文献】