慢加急性肝衰竭患者中乙型肝炎病毒S区基因准种与疾病关系的研究

发布时间：2018-05-18 20:19

本文选题：慢性乙型肝炎 + 乙型肝炎病毒　；参考：《蚌埠医学院》2013年硕士论文

【摘要】：目的：本课题通过检测慢性乙肝组和慢加急性肝衰竭组患者之间HBV基因S区准种条带数，探讨HBV基因的S区准种的分布特点与肝脏疾病发展之间的关系。方法：选取慢加急性肝衰竭患者20例以及对照组慢性乙型肝炎患者20例。取其空腹静脉血，ELISA检测乙肝两对半，提取血清HBV-DNA，检测HBV-DNA载量。测定HBV基因分型，将血清中HBV-DNA经巢氏PCR扩增后的产物进行2%的琼脂糖凝胶电泳分析。对所有血清标本进行SSCP分析，以观察患者血清中HBV-DNA的准种情况。应用SPSS17.0软件包对数据进行统计学分析。结果：1.两组患者在性别、年龄、基因型和HBeAg的状态之间无统计学差异（P＞0.05）。HBV-DNA载量、血清总胆红素（TBIL）、凝血时间（PT）及凝血酶原活动度（PTA%）之间差异有统计学意义（P＜0.05）。 2.慢性乙肝患者与肝衰竭患者准种条带间比较差异有统计学意义（P＜0.05），肝衰竭患者血清内HBV-DNA基因S区的准种复杂度高于慢性乙肝的患者。 3.在慢性乙肝的患者中HBV基因型为B型和C型的患者PCR-SSCP条带数比较差异无统计学意义（P＞0.05）；在肝衰竭患者中HBV基因型为B型的患者准种条带数要多于C型的患者，，差异有统计学意义（P＜0.05）。从总体上来说，HBV基因为B型的准种条带数要多于C型感染者。 4.慢性乙肝和肝衰竭患者中HBeAg阴性的准种条带数大于HBeAg阳性的，差异有统计学意义（P＜0.05）。 5.慢乙肝和肝衰竭患者的准种条带数与其ALT和HBV-DNA载量进行相关性分析，发现ALT和HBV-DNA载量与准种数之间无相关性，差异无统计学意义（P＞0.05）。结论： 1.证实了未经抗病毒治疗的慢性乙肝及慢加急性肝衰竭体内HBV基因S区有准种的存在。 2.慢性乙肝患者SSCP准种的条带数比慢加急性肝衰竭患者的要少，差异有统计学意义。 3.慢性乙肝患者中基因型为B型和C型的准种条带差异无统计学意义；肝衰竭患者中基因型为B型要比C型的准种条带数多。总的来说，HBV基因为B型的准种条带数要多于C型感染者。 4.慢乙肝患者和肝衰竭患者中，其HBeAg阴性的患者其准种条带数大于HBeAg阳性的患者。 5.ALT和HBV-DNA载量与准种条带数无线性相关，说明准种异质性的增加与宿主、病毒自身、免疫机制以及外界环境有关。
[Abstract]:Objective: to investigate the relationship between the distribution of S region quasispecies of HBV gene and the development of liver disease by detecting the number of S region quasispecies of HBV gene in chronic hepatitis B group and chronic and acute hepatic failure group. Methods: 20 patients with chronic liver failure and 20 patients with chronic hepatitis B were selected. The serum HBV-DNA was extracted and the HBV-DNA load was detected by Elisa. The genotyping of HBV was determined. The products of HBV-DNA amplified by nested PCR in serum were analyzed by 2% agarose gel electrophoresis. All serum samples were analyzed by SSCP to observe the quasi-species of HBV-DNA in patients' serum. The data were analyzed by SPSS17.0 software package. The result is 1: 1. There was no significant difference in sex, age, genotype and HBeAg status between the two groups (P > 0.05).HBV-DNA). There was significant difference in serum total bilirubin (Tbilirubin), coagulation time (PTT) and prothrombin activity (P < 0.05) between the two groups. 2. There was significant difference in quasispecies bands between patients with chronic hepatitis B and patients with liver failure (P < 0.05). The quasispecies complexity of S region of HBV-DNA gene in serum of patients with liver failure was higher than that of patients with chronic hepatitis B. 3. There was no significant difference in the number of PCR-SSCP bands between patients with HBV genotype B and type C in patients with chronic hepatitis B (P > 0.05), but the number of quasispecies bands in patients with HBV genotype B was more than that in patients with type C (P < 0.05). Generally speaking, the number of B type quasispecies bands was more than that of C type infection. 4. In patients with chronic hepatitis B and liver failure, the number of HBeAg negative quasispecies bands was higher than that of HBeAg positive, the difference was statistically significant (P < 0.05). 5. The correlation analysis between the number of quasispecies bands and the load of ALT and HBV-DNA in patients with chronic hepatitis B and liver failure showed that there was no correlation between the number of ALT and HBV-DNA and the number of quasispecies, but the difference was not statistically significant (P > 0.05). Conclusion: 1. It was confirmed that there were quasispecies in S region of HBV gene in chronic hepatitis B and chronic and acute liver failure without antiviral therapy. 2. The number of SSCP quasispecies in chronic hepatitis B patients was less than that in chronic hepatitis B patients with acute liver failure. 3. There was no significant difference between genotype B and C in patients with chronic hepatitis B, but there were more quasispecies bands with genotype B in patients with liver failure than those with type C. Generally speaking, the number of B type quasi-species bands was higher than that of C-type infection. 4. In patients with chronic hepatitis B and liver failure, the number of quasispecies bands in HBeAg negative patients was higher than that in HBeAg positive patients. The quantity of 5.ALT and HBV-DNA was correlated with the number of quasispecies bands, indicating that the increase of quasispecies heterogeneity was related to host, virus itself, immune mechanism and external environment.
【学位授予单位】：蚌埠医学院
【学位级别】：硕士
【学位授予年份】：2013
【分类号】：R512.62

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