四川遂宁地区乙型病毒性肝炎血清流行病学调查及乙肝病毒基因型研究

发布时间：2018-06-02 08:44

本文选题：乙型肝炎病毒 + 血清流行病学　；参考：《中国疾病预防控制中心》2010年硕士论文

【摘要】： 目的：了解遂宁地区人群乙型肝炎病毒(HBV)的感染现状及病毒基因型及血清亚型流行特征；评价乙肝疫苗纳入儿童免疫策略后的效果,为进一步制定乙肝的防制策略提供科学依据。方法： (1)抽样方法：在遂宁六个县级行政区域内,采用多阶段整群随机抽样方法,在1-59岁常住人口选取1～4岁、5～14岁、15～59岁三个年龄组,抽取符合调查要求的调查对象,共采集血清样本1468人份。 (2)检测方法：用酶联免疫法(ELISA)检测乙肝病毒表面抗原(HBsAg)、乙肝病毒表面抗体(抗-HBs)和乙肝病毒核心抗体(抗-HBc)；对乙肝病毒表面抗原(HBsAg)检测阳性的血清样本进行HBV DNA提取,用巢氏PCR法扩增提取HBV DNAS区,根据PCR产物基因测序结果对样本HBV进行基因分型。 (3)统计方法：所有资料录入EpiData3.1数据库后,用SPSS13.0软件进行统计处理和分析。结果：(1)HBV感染标志血清流行病学特征(经标化后)：人群中HBsAg阳性率为16.83%,抗-HBs阳性率为43.71%,HBV感染率为77.83%。各年龄组之间HBsAg阳性率、HBV感染率差异有显著的统计学意义(x2分别为48.01、259.55,P0.001)；人群中HBsAg阳性率男性和女性有显著性差异(x2=11.14,p0.05)；不同地区人群HBsAg阳性率、HBV感染率均有显著性差异(x2分别为33.56、60.17,p均0.01)；不同职业人群HBsAg阳性率、HBV感染率均有显著性差异(x2分别为36.32、235.73,p均0.001)；不同文化程度人群HBsAg阳性率、HBV感染率均有显著性差异(x2分别为37.95、123.31,p均0.001)；1992年后出生人群组HBsAg阳性率明显低于1992年前出生人群组(x2=33.92,p0.01) (2)HBsAg阳性标本病毒基因型分型结果：118例HBsAg阳性标本中,B基因型40例(33.89%),C基因型73例(61.86%),D基因型5例(4.23%),未发现BCD以外的其他基因型。 (3) HBsAg阳性标本病毒血清亚型分型结果：在118份样品中42份(35.59%)为adr型,76份(64.41%)为adw型。结论：1、遂宁地区仍是乙肝高流行地区,乙肝疫苗大规模在低年龄段人群实施接种已达到一定效果并使该地区乙肝流行病学特征发生改变,但目前低年龄组人群HBsAg携带率仍高于全国平均水平。 2、遂宁地区乙肝病毒基因型别以B、C为主要基因型,其中C型基因占优势,存在少量D基因型。血清亚型的分布以adr\adw亚型为主,其中adw亚型占优势。
[Abstract]:Objective: to investigate the present situation of hepatitis B virus (HBV) infection and the epidemic characteristics of HBV genotype and serum subtype in the population of Suining, and to evaluate the effect of hepatitis B vaccine in children's immunization strategy. To provide scientific basis for the further formulation of hepatitis B prevention and control strategy. Methods: (1) sampling method: in six county administrative districts in Suining, a multi-stage cluster random sampling method was used to select three age groups of 1 to 59 years old resident population aged 1 to 59 years, and to select the survey subjects who met the requirements of the survey. A total of 1468 serum samples were collected. Methods: Elisa was used to detect hepatitis B virus surface antigen (HBsAg), anti-HBsAg and anti-HBc antibody (anti-HBcG). HBV DNA was extracted from serum samples which were positive for HBV surface antigen (HBs). The extracted HBV DNAS region was amplified by nested PCR and genotyping of sample HBV was carried out according to the result of PCR product gene sequencing. Statistical method: after all data are entered into EpiData3.1 database, statistical processing and analysis are carried out with SPSS13.0 software. Results the seroepidemiologic characteristics of the HBV infection marker were as follows: the positive rate of HBsAg and anti-HBs were 16.83and 43.71respectively, and the infection rate of HBV-positive was 77.830.The positive rate of anti-HBs was 43.71and the positive rate of anti-HBs was 77.83. There were significant differences in HBsAg positive rate and HBsAg infection rate among different age groups (48.01259.55p 0.001, P 0.001), there was significant difference in HBsAg positive rate between male and female, and there was significant difference in HBsAg positive rate and HBsAg infection rate among different population in different area. The positive rates of HBsAg in different occupational groups were significantly different. The positive rates of HBsAg were 36.32235.73 (P = 0.001), and the positive rates of HBsAg were significantly different among people with different educational levels (P < 0.01). The positive rates of HBsAg were 37.95123.31 (P = 0.001), respectively, and those of those born after 1992 were significantly higher than those of controls. The positive rate of HBsAg in the cohort was significantly lower than that in the pre-1992 group (P 0.01). The results of virus genotyping in HBsAg positive specimens of 10% HBsAg positive samples were as follows: among the 118 HBsAg positive specimens, 40 cases were of B genotype or 33.89%, and 73 cases of BCD C genotype (73 cases). There were 5 cases (4.23%) of D genotype and 5 cases (4. 23%). No genotype other than BCD was found. (3) the results of serotyping of HBsAg positive specimens: 42 of 118 samples were of adr type (64.41) and 42 of them were of adw type. ConclusionThe area of Suining is still a high epidemic area of hepatitis B, the large scale inoculation of hepatitis B vaccine in the low age group has achieved certain effect and changed the epidemiological characteristics of hepatitis B in this area. However, the HBsAg carrying rate in the low age group is still higher than the national average. 2. The main genotype of hepatitis B virus gene in Suining area was BHV C, in which type C gene was dominant, and a small number of genotype D existed. The distribution of serum subtypes was mainly adr\ adw, in which adw subtype was dominant.
【学位授予单位】：中国疾病预防控制中心
【学位级别】：硕士
【学位授予年份】：2010
【分类号】：R512.62;R181.3

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