肝炎相关病毒在新生儿黄疸中分布及对肝脏损伤的研究

发布时间：2018-06-03 23:15

  本文选题：肝炎相关病毒 + 新生儿黄疸　； 参考：《青岛大学》2016年硕士论文

【摘要】：目的:1、了解目前在淄博地区的新生儿人群中黄疸发生的的现状。2、分析引起新生儿黄疸病毒感染的主要病原体,确定最适合新生儿黄疸病毒感染的联合检测首选套餐。3、确定引起新生儿黄疸主要的病毒及其在母乳存在的相关性分析。4、新生儿感染肝炎相关病毒后对其本身肝脏造成损伤的情况分析。材料和方法:收集淄博地区(淄博市第三人民医院和淄博市张店区人民医院)2013年2月至2014年10月入院的新生儿血液和及其母亲乳汁各1427份,用荧光定量PCR方法及酶联免疫吸附试验(ELISA)的方法检测新生儿外周血中人巨细胞病毒(HCMV)、单纯疱疹病毒(HSV)、甲肝病毒(HAV)、乙肝病毒(HBV)、丙肝病毒(HCV)、EB病毒(EBV)等病毒的情况,并进行统计学处理;将引起新生儿人群中出现黄疸的主要感染病毒对其母亲乳汁进行回顾性相关病毒检测,并进行统计学比较;对引起新生儿黄疸的主要病毒的阳性血清样本在全自动生化分析仪上进行肝功能主要指标进行检测分析,统计肝功能检测指标结果,并与所选的对照组进行统计比较。结果:1、1427例标本中病毒感染阳性数274例,其中HCMV 157例(11.00%)、HAV-Ig M 2例(0.14%)、HBV 92例(6.45%)、HCV-Ig M 3例(0.21%)、HSV-II-Ig M 12例(0.84%)、EBV 8例(0.56%)。HCMV和HBV占据比例较高,在病毒感染中分别占11.00%和6.45%。2、黄疸组中HCMV阳性为145例,非黄疸组HCMV阳性为12例,两组HCMV差异显著,差异有统计学意义(p0.01)。3、1427例新生儿血液标本中,HCMV阳性157(11.0%)例,阴性1270(89.0%)例;1427例母亲乳汁样本,HCMV阳性849(59.50%)例,阴性578(40.50%)例;对比差异显著,有统计学意义(p0.01)。4、黄疸组中HCMV阳性者肝脏功能TBIL、GGT、AST、ALT等各项指标都高于HCMV阴性者,两者比较有统计学意义(p0.01)。结论:淄博地区黄疸新生儿病毒的感染主要是HCMV与HBV,其中HCMV157例(57.30%),占据一半以上,说明在本地区HCMV感染几率较高,应引起高度关注。在新生儿黄疸患儿病毒检测时可优先考虑这两项检测,以达到最经济而又最快的找到原因,及时治疗。新生儿血液标本HCMV阳性率(11.0%)低于新生儿母亲乳汁样本(59.5%),因此尽早对母亲进行相关HCMV的检测也很有意义,这样可降低因喂养母乳而引起新生儿感染病毒。黄疸组HCMV阳性者肝脏功能TBIL、GGT、AST、ALT检测指标等都高于HCMV阴性者,两者比较差异显著,说明新生儿在巨细胞病毒感染后肝脏的损伤程度比未感染巨细胞病毒的肝脏损伤程度大。
[Abstract]:Objective: 1, to understand the status quo of jaundice in the newborns in Zibo area, and to analyze the main pathogens of neonatal jaundice virus infection. To determine the most suitable combination of neonatal jaundice virus infection. 3, determine the main causes of neonatal jaundice virus and its correlation in breast milk analysis. 4. Newborns infected with hepatitis associated virus on their own liver Analysis of the damage caused. Materials and methods: 1427 neonatal blood samples and their mothers' milk were collected from February 2013 to October 2014 in Zibo region (Zibo third people's Hospital and Zibo Zhangdian District people's Hospital). Human cytomegalovirus (HCMV), herpes simplex virus (HSV), hepatitis A virus (HAV), hepatitis B virus (HBV), hepatitis C virus (HCV) and Epstein-Barr virus (EBV) in the peripheral blood of neonates were detected by fluorescence quantitative PCR and enzyme linked immunosorbent assay (Elisa). The main infection virus causing jaundice in the newborns was detected by retrospective analysis of the mother's milk related virus, and statistical comparison was carried out. The positive serum samples of the main virus causing neonatal jaundice were detected and analyzed on the automatic biochemical analyzer to analyze the main indexes of liver function, and the results of liver function were counted and compared with those of the control group. Results there were 274 cases of viral infection in 1 427 specimens, of which HCMV 157 cases (11.00%) and HAV-Ig M (2 cases) 0.145.92 cases with HCV-Ig M 3 cases with HCV-Ig M 0.21% with HSV-II-Ig M 12 cases with 0.84EBV 8 cases with 0.56.HCMV and HBV accounted for 11.00% and 6.45.2in jaundice group, the positive rate of HCMV was 14.5 cases, and the positive rate of HCMV was 11.00% and 6.45.2in the jaundice group, the positive rate of HCMV was 0.56% and 6.45% respectively, and the positive rate of HCMV was 6.45% in the jaundice group, and the positive rate was 6.45% in the jaundice group. In non-jaundice group, 12 cases were HCMV positive, and the difference between the two groups was significant. The difference was statistically significant in 1570.11.0% of the blood samples of newborns, 1427 cases were negative (12700.89.0), 1427 cases were positive in milk samples of mothers (84959.50), and 578% (40.50%), the difference was significant. In jaundice group, the liver function of HCMV positive group was higher than that of HCMV negative group. Conclusion: the infection of jaundice neonatal virus in Zibo area is mainly HCMV and HBV, among which 57.30 cases of HCMV157 account for more than half, indicating that the probability of HCMV infection is high in this area, which should be paid close attention to. In order to find the most economical and quickest cause, we can give priority to these two tests in the detection of neonatal jaundice virus and treat them in time. The positive rate of HCMV in blood samples of newborns was lower than that of breast milk samples of newborns, so it was also significant to detect the related HCMV of mothers as soon as possible, which could reduce the infection of newborns caused by breast-feeding. In jaundice group, the liver function of HCMV positive group was higher than that of HCMV negative group, indicating that the degree of liver damage in newborns after CMV infection was greater than that in uninfected cytomegalovirus group.
【学位授予单位】：青岛大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R722.17
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本文编号：1974653