河北省部分地区人巨细胞病毒激活感染的流行病学调查
发布时间：2018-10-14 14:42
【摘要】： 目的:自从Fabricant等以Marek病毒(一种禽类病毒)感染鸡而引起动脉粥样硬化以来,动脉粥样硬化的病毒病因学说受到越来越多学者的关注,人巨细胞病毒(Humancytomegalovirus,HCMV)被认为是与动脉粥样硬化关系最密切的一种病毒。本课题组的研究结果已证明临床HCMV的激活感染是动脉粥样硬化的独立危险因素之一,关于这一课题,国内外的许多学者从不同的角度进行了相关研究,有关HCMV感染与动脉粥样硬化间关系的实验室研究已有大量文献报道,但研究结果仍存在争议,而且实验室环境不能准确反映暴露于外部世界的真实条件,而流行病学则通过直接研究自然环境下的人群而避免了这类问题,实验室研究同流行病学调查的结合将对这一课题从不同的角度进行探讨。现有的流行病学资料多集中于孕妇、新生儿、献血员、器官移植者及免疫缺陷者(如多发性硬化、AIDS患者等),调查人群层面单一,不能反映整体人群HCMV的感染状况。HCMV-pp65是一种重要的晚期抗原,HCMV活动性感染时HCMV-pp65表达于外周血单核细胞、中性多形核白细胞和血管内皮细胞中,而潜伏感染时表达极低,现已成为国际公认的诊断HCMV活动性感染的标准方法之一。我们将在河北省11个行政区域内进行相关的流行病学调查,检测HCMV-pp65,并随访调查人群,进行前瞻性研究,观察其动脉粥样硬化性疾病尤其是脑梗死的发生情况,从流行病学角度探讨动脉粥样硬化与HCMV的关系,进一步探讨动脉粥样硬化的病因及相关危险因素,进而寻找防治缺血性脑血管病的新模式,这也是我们进行此次流行病学调查的主要目的。 方法:本研究采用免疫组织化学方法检测静脉血白细胞中的巨细胞病毒晚期抗原pp65,对河北省部分地区(包括石家庄市、藁城市、柳辛庄、赵县、高阳、蠡县、阜平、献县、赞皇、南皮、涉县、武邑、崇礼)人群巨细胞病毒的激活感染HCMV-pp65阳性率进行了流行病学调查,共1954例,其中男性781例,女性1173例,平均年龄(55.16±10.30)岁。各县、市按行政地域分成六个地区:石家庄地区、保定地区、沧州地区、邯郸地区、张家口地区和衡水地区。 利用microsoft excel建立数据库,将数据库资料导入为SAS数据集,利用SAS 6.12统计软件对所调查人群HCMV-pp65阳性率及其与地域、年龄、性别等相关因素进行统计学分析。计数资料采用x~2检验或校正的x~2检验,α=0.05。 结果:1对河北省13个县区的1954例调查对象抽取静脉血检测人巨细胞病毒晚期抗原pp65,免疫组化染色后,阴性细胞为均匀一致的蓝紫色,阳性细胞胞浆和(或)胞核为棕黄色,阳性细胞数大于1/50000判为pp65抗原阳性。 2河北省部分地区人群抽血检测人巨细胞病毒晚期抗原pp65,共1954例,其中农村1807例,城镇147例,平均年龄(55.16±10.30)岁,计算得出pp65阳性率17.14%。总体人群pp65阳性率在性别间差异无统计学意义,x~2=0.283,P＞0.05;年龄分组pp65阳性率差异有统计学意义,x~2=8.688,P＜0.05,以60-年龄组最高(20.74%),40-年龄组最低(14.11%);地区间pp65阳性率差异有统计学意义,x~2=55.246,P＜0.05,以保定地区最高(26.65%),依次为沧州(23.32%)、邯郸(22.22%)、张家口(19.57%)、衡水(11.95%)、石家庄(11.49%)。 3农村人群组1807例,平均年龄(55.87±10.19)岁,计算得出外周血pp65阳性率18.04%。农村人群pp65阳性率在性别间差异无统计学意义,x~2=1.948,P＞0.05;年龄分组pp65阳性率差异无统计学意义,x~2=6.824,P＞0.05;地区间pp65阳性率差异有统计学意义,x~2=44.386,P＜0.05,以保定地区最高(26.65%),依次为沧州(23.32%)、邯郸(22.22%)、张家口(19.57%)、石家庄(12.52%)、衡水(11.95%)。 4城镇人群组147例,平均年龄(46.87±7.54)岁,计算得出外周血pp65阳性率6.12%。城镇人群pp65阳性率在性别间差异无统计学意义,x~2=0.035,P＞0.05;年龄分组pp65阳性率差异无统计学意义,x~2=1.624,P＞0.05。 5农村与城镇人群外周血pp65阳性率比较差异有统计学意义,x~2=13.594,P＜0.05。 6平原地区与山区人群外周血pp65阳性率比较差异无统计学意义,x~2=2.396,P＞0.05。 结论:1河北省部分地区调查人群中HCMV-pp65阳性率为17.14%,说明普通人群中存在HCMV的激活感染; 2河北省各地区间存在HCMV-pp65阳性率的显著性差异; 3 HCMV-pp65阳性率性别间差异无统计学意义,但男性略高于女性; 4总体人群年龄分组HCMV-pp65阳性率区组间差异有统计学意义,而农村组和城镇组年龄分组差异均无统计学意义,但随年龄增加HCMV-pp65阳性率有上升趋势; 5农村与城镇人群HCMV-pp65阳性率比较差异有统计学意义,农村明显高于城镇; 6平原地区和山区HCMV-pp65阳性率无显著性差异; 7由研究结果推测所调查地区总体健康人群中HCMV的激活感染率应低于17.14%。
[Abstract]:AIM: Since Fabricant et al. has caused atherosclerosis since the infection of Marek's virus (an avian virus), the etiology of atherosclerosis has attracted more and more attention from scholars, human cytomegalovirus (human cytomegalovirus), HCMV) is believed to be the most closely related to atherosclerosis. The results of our research team have shown that the activation infection of HCMV is one of the independent risk factors of atherosclerosis. Laboratory studies on the relationship between HCMV infection and atherosclerosis have been reported in a large number of literature, but the results of the study are still in dispute, and the laboratory environment cannot accurately reflect the real conditions exposed to the outside world, Epidemiological studies have avoided this problem by directly studying the population in the natural environment, and the combination of laboratory research and epidemiological investigation will discuss this subject from different angles. The current epidemiological data is concentrated in pregnant women, newborns, blood donors, organ transplant recipients and immunodeficient persons (such as multiple sclerosis, AIDS patients, etc.). HCMV pp65 is an important late antigen, HCMV-pp65 is expressed in peripheral blood monocytes, polymorphonuclear leukocytes and vascular endothelial cells when HCMV activity is infected. We will conduct relevant epidemiological investigation in 11 administrative regions of Hebei Province, detect HCMV pp65, follow up the investigation population, conduct prospective study, observe the occurrence of atherosclerotic disease, especially cerebral infarction. The relationship between atherosclerosis and HCMV was discussed from the angle of epidemiology, the cause of atherosclerosis and related risk factors were further studied, and the new model of prevention and treatment of ischemic cerebrovascular disease was found, which was also the main purpose of this epidemiological investigation. Methods: In this study, we used immunohistochemical method to detect the late antigen pp65 of giant cell virus in venous blood cells. The positive rate of HCMV pp65 in human cytomegalovirus (HCMV-pp65) in the population of Wuyi and Chongli was investigated in 1954. Among them, 781 cases were male, 1173 were female, and the average age (55. 16) was 10. 3. 0). The city is divided into six areas according to the administrative region: Shijiazhuang, Inner Mongolia, Cangzhou, Wenzhou, Zhangjiakou and Heng The database was established by microsoft excel, the database data were imported into SAS data set, and the positive rate of HCMV pp65 in the investigated population and its related factors, such as geography, age, sex, etc. were analyzed by SAS 6.12 statistical software. Statistical analysis. The count data is x ~ 2 test or corrected x ~ 2 test Results: 1 of the 1954 survey subjects in 13 counties in Hebei Province were recruited to detect the late antigen pp65 of human cytomegalovirus in venous blood, and the negative cells were uniformly consistent blue-purple and positive cells after immunohistochemical staining. The cytoplasm and/ or nucleus are brown, and the number of positive cells is greater than 1/ 5000. 0 was positive for pp65 antigen. A total of 1954 cases were detected by blood draw in some areas of Hebei Province. Among them, there were 1807 rural areas, 147 towns, and an average age (55. 16, 10. 30). The positive rate of pp65 was 17. 14%. The positive rate of pp65 in general population was not statistically significant, x ~ 2 = 0.283, P> 0.05; the positive rate of pp65 in age group was statistically significant, x ~ 2 = 8.688, P <0.05, the highest (20.74%) in 60-age group and 40-age group (14. 11%). The accounting significance, x ~ 2 = 55. 246, P <0.05, was the highest (26.65%), the highest (23.32%) in Cangzhou (23.32%), Zhangjiakou (19. 57%), Hengshui (11. 9). 5%), Shijiazhuang (11.49%). In the rural population group, 1807, mean age (55. 87, 10.19) years old, count The positive rate of pp65 in rural population was 18. 04%. The positive rate of pp65 in rural population was not statistically significant, x ~ 2 = 1. 948, P> 0.05; the positive rate of pp65 in age group was not statistically significant, x ~ 2 = 6.824, P> 0.05; the positive rate of pp65 positive rate was statistically significant, x ~ 2 = 44. 386, P <0 05, the highest (26. 65%) in the area of Shijiazhuang, Cangzhou (23. 32%), Shijiazhuang city (22. 22%), Zhangjiakou (19. 57%), Shijiazhuang (12.52%), Hengshui (11.95%). 147 cases of urban population group, average age (46. 87) 7.5 The positive rate of pp65 in urban population was 6. 12%. The positive rate of pp65 in urban population was not statistically significant. The positive rate of p65 in the peripheral blood of rural and urban population was higher than that in urban population without statistical significance, x2 = 1.624, P> 0.05. 5. The difference was statistically significant, x ~ 2 = 13. 594, P <0.05. 6 Plain area and peripheral blood pp6 in mountainous area. 5. There was no statistical significance in the positive rate of positive rate, x2 = 2.396, P> 0.05. Conclusion: The HCM in the survey population in some areas of Hebei Province The positive rate of V-pp65 was 17. 14%, indicating the presence of HCM in the general population. V activation infection; HCMV pp65 positive rate in different regions of Hebei province There was no significant difference between the positive rate of HCMV pp65 and the positive rate of HCMV pp65, but there was a statistically significant difference between the positive rate of HCMV pp65 and the positive rate of HCMV pp65. The differences of age groups in rural and urban groups were not statistically significant, but increased with age. CMV-pp65 yang a rising trend in sexual rates; HCMV-pp in rural and urban populations. 65 Positive rates were statistically significant, and rural areas were significantly higher than towns; in plain areas and mountain areas HCM
【学位授予单位】：河北医科大学
【学位级别】：硕士
【学位授予年份】：2008
【分类号】：R181.3
本文编号：2270781
[Abstract]:AIM: Since Fabricant et al. has caused atherosclerosis since the infection of Marek's virus (an avian virus), the etiology of atherosclerosis has attracted more and more attention from scholars, human cytomegalovirus (human cytomegalovirus), HCMV) is believed to be the most closely related to atherosclerosis. The results of our research team have shown that the activation infection of HCMV is one of the independent risk factors of atherosclerosis. Laboratory studies on the relationship between HCMV infection and atherosclerosis have been reported in a large number of literature, but the results of the study are still in dispute, and the laboratory environment cannot accurately reflect the real conditions exposed to the outside world, Epidemiological studies have avoided this problem by directly studying the population in the natural environment, and the combination of laboratory research and epidemiological investigation will discuss this subject from different angles. The current epidemiological data is concentrated in pregnant women, newborns, blood donors, organ transplant recipients and immunodeficient persons (such as multiple sclerosis, AIDS patients, etc.). HCMV pp65 is an important late antigen, HCMV-pp65 is expressed in peripheral blood monocytes, polymorphonuclear leukocytes and vascular endothelial cells when HCMV activity is infected. We will conduct relevant epidemiological investigation in 11 administrative regions of Hebei Province, detect HCMV pp65, follow up the investigation population, conduct prospective study, observe the occurrence of atherosclerotic disease, especially cerebral infarction. The relationship between atherosclerosis and HCMV was discussed from the angle of epidemiology, the cause of atherosclerosis and related risk factors were further studied, and the new model of prevention and treatment of ischemic cerebrovascular disease was found, which was also the main purpose of this epidemiological investigation. Methods: In this study, we used immunohistochemical method to detect the late antigen pp65 of giant cell virus in venous blood cells. The positive rate of HCMV pp65 in human cytomegalovirus (HCMV-pp65) in the population of Wuyi and Chongli was investigated in 1954. Among them, 781 cases were male, 1173 were female, and the average age (55. 16) was 10. 3. 0). The city is divided into six areas according to the administrative region: Shijiazhuang, Inner Mongolia, Cangzhou, Wenzhou, Zhangjiakou and Heng The database was established by microsoft excel, the database data were imported into SAS data set, and the positive rate of HCMV pp65 in the investigated population and its related factors, such as geography, age, sex, etc. were analyzed by SAS 6.12 statistical software. Statistical analysis. The count data is x ~ 2 test or corrected x ~ 2 test Results: 1 of the 1954 survey subjects in 13 counties in Hebei Province were recruited to detect the late antigen pp65 of human cytomegalovirus in venous blood, and the negative cells were uniformly consistent blue-purple and positive cells after immunohistochemical staining. The cytoplasm and/ or nucleus are brown, and the number of positive cells is greater than 1/ 5000. 0 was positive for pp65 antigen. A total of 1954 cases were detected by blood draw in some areas of Hebei Province. Among them, there were 1807 rural areas, 147 towns, and an average age (55. 16, 10. 30). The positive rate of pp65 was 17. 14%. The positive rate of pp65 in general population was not statistically significant, x ~ 2 = 0.283, P> 0.05; the positive rate of pp65 in age group was statistically significant, x ~ 2 = 8.688, P <0.05, the highest (20.74%) in 60-age group and 40-age group (14. 11%). The accounting significance, x ~ 2 = 55. 246, P <0.05, was the highest (26.65%), the highest (23.32%) in Cangzhou (23.32%), Zhangjiakou (19. 57%), Hengshui (11. 9). 5%), Shijiazhuang (11.49%). In the rural population group, 1807, mean age (55. 87, 10.19) years old, count The positive rate of pp65 in rural population was 18. 04%. The positive rate of pp65 in rural population was not statistically significant, x ~ 2 = 1. 948, P> 0.05; the positive rate of pp65 in age group was not statistically significant, x ~ 2 = 6.824, P> 0.05; the positive rate of pp65 positive rate was statistically significant, x ~ 2 = 44. 386, P <0 05, the highest (26. 65%) in the area of Shijiazhuang, Cangzhou (23. 32%), Shijiazhuang city (22. 22%), Zhangjiakou (19. 57%), Shijiazhuang (12.52%), Hengshui (11.95%). 147 cases of urban population group, average age (46. 87) 7.5 The positive rate of pp65 in urban population was 6. 12%. The positive rate of pp65 in urban population was not statistically significant. The positive rate of p65 in the peripheral blood of rural and urban population was higher than that in urban population without statistical significance, x2 = 1.624, P> 0.05. 5. The difference was statistically significant, x ~ 2 = 13. 594, P <0.05. 6 Plain area and peripheral blood pp6 in mountainous area. 5. There was no statistical significance in the positive rate of positive rate, x2 = 2.396, P> 0.05. Conclusion: The HCM in the survey population in some areas of Hebei Province The positive rate of V-pp65 was 17. 14%, indicating the presence of HCM in the general population. V activation infection; HCMV pp65 positive rate in different regions of Hebei province There was no significant difference between the positive rate of HCMV pp65 and the positive rate of HCMV pp65, but there was a statistically significant difference between the positive rate of HCMV pp65 and the positive rate of HCMV pp65. The differences of age groups in rural and urban groups were not statistically significant, but increased with age. CMV-pp65 yang a rising trend in sexual rates; HCMV-pp in rural and urban populations. 65 Positive rates were statistically significant, and rural areas were significantly higher than towns; in plain areas and mountain areas HCM
【学位授予单位】：河北医科大学
【学位级别】：硕士
【学位授予年份】：2008
【分类号】：R181.3
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