新疆652例汉、维、哈族HCV感染者病毒基因型研究

发布时间：2018-01-18 07:16

本文关键词：新疆652例汉、维、哈族HCV感染者病毒基因型研究　出处：《新疆医科大学》2015年硕士论文　论文类型：学位论文

【摘要】：目的:分析新疆某三甲医院的汉、维、哈族HCV感染者的病毒基因型,了解三个民族HCV感染主要基因型的差异。应用逆转录PCR扩增和反向点杂交技术进行HCV基因分型的检测方法,初步了解汉、维、哈族HCV感染者病毒基因型特点,为新疆地区HCV的基础研究、临床治疗和疾病预防提供依据。方法:收集2014年新疆某三甲医院诊断为丙型肝炎的汉、维、哈族感染者血清标本,先进行荧光定量PCR检测病毒载量,载量大于1×103 copies/ml的再用PCR-反向点杂交法进行HCV基因分型检测。结果:669份HCV感染血清样本PCR-反向点杂交基因分型成功652例,检出率为97.4%(652/669),检出6种基因型,分别为1b、2a、3a、3b、6a以及混合型1b/2a,其中1b型395例(60.58%),2a型188例(28.83%)。1b、2a型分布在汉、维、哈族之间有差异,且差异有统计学意义(P0.05)。男性HCV感染者中2a型和女性HCV感染者中1b、2a型在汉、维、哈族构成比中有差异,且差异有统计学意义(P0.05)。乌鲁木齐地区HCV感染者中,2a型在汉、维、哈族病例分布有差异,且差异有统计学意义(P0.05)。其他地区HCV感染者中,1b、2a型在汉、维、哈族分布中有差异,且差异有统计学意义(P0.05),在哈族病例中,1b、2a型所占比例较高,尤其是2a型,所占比例高于汉族、维族病例。1b型HCV感染者在各临床类型分布中有差异,且差异有统计学意义(P0.05),丙肝相关肝癌中,1b型所占比例较高,达83.33%。1b型的平均RNA载量为(1.41×106±1.43×105)copies/ml,2a型的平均RNA载量为(7.84×105±1.43×105)copies/ml,两者差异有统计学意义(P0.05)。载量水平(1.00×104~9.99×104)和(1.00×107~9.99×107),在1b、2a型和其他型之间有差异,差异有统计学意义(P0.05)。结论:新疆652例HCV感染者病毒基因型以1b型为主,其次是2a型,1b、2a型在汉、维、哈族丙型肝炎患者中存在差异。新疆的民族分布特征与其他北方内陆城市有一定差异,这可能是导致HCV基因型分布与以往报道的流行病学分布特征不一致的原因之一。6个基因型(1b,2a,3a,3b,6a,1b/2a型)在男女性别中的差异,各基因型构成均无性别差异。但按性别分层统计,结果显示,男女性丙肝感染者中,分别在2a型、1b、2a型中汉、维、哈族构成比有差异。这一差异可能与三个民族的生活习惯、受教育程度、贫富差距及种族基因型等因素有关。1b型HCV对肝脏的损伤要比其他亚型严重的多,且临床上其对干扰素的治疗方案和周期以及治疗效果也不尽相同。了解HCV基因分型区域分布特征具有很重要的临床及流行病学意义。对了解新疆地区丙型肝炎患者的HCV基因分型情况提供了重要资料,同时对于丙型病毒性肝炎的流行病学研究、判断病情和预后及观察抗病毒疗效提供了宝贵的资源。
[Abstract]:Objective: to analyze the genotypes of HCV infected Chinese, Uygur and Kazakh in a third class hospital in Xinjiang. To understand the difference of the main genotypes of HCV infection among the three nationalities, HCV genotyping was detected by reverse transcription PCR amplification and reverse dot hybridization, and the Chinese and Uygur were preliminarily understood. The genotypic characteristics of HCV in Kazakh people infected with HCV are the basic study of HCV in Xinjiang. Methods: in 2014, the serum samples of Chinese, Uygur and Kazakh people infected with hepatitis C were collected from a third class hospital in Xinjiang, and the viral load was detected by fluorescence quantitative PCR. HCV genotyping was detected by PCR- reverse dot hybridization when the load was more than 1 脳 10 ~ 3 copies/ml. Results:. 669 serum samples of HCV infection were classified successfully by PCR- reverse dot hybridization. The detection rate was 97.4 / 662 / 669 and 6 genotypes were detected, which were 1b / 2a, 3a / 3a / 3b / 6a and 1b / 2a, respectively. Among them, 395 cases of 1b type (60.58) had a difference between Han, Uygur and Kazakh ethnic groups. 188 cases of type 28. 83a were distributed in Han, Uygur and Kazakh ethnic groups. The difference was statistically significant (P 0.05). There were differences in the composition ratio of Han, Uygur and Kazakh ethnic groups between male HCV infected patients and female HCV infected patients. The difference was statistically significant (P 0.05). The distribution of HCV type 2a in Han, Uygur and Kazakh nationalities was different in Urumqi. The difference was statistically significant (P 0.05). There was significant difference in the distribution of HCV 2a in Han, Uygur and Kazakh ethnic groups, and the difference was statistically significant (P0.05). In Kazakh nationality, the proportion of type 2a was higher than that of Han nationality, especially the rate of 2a. The distribution of Uygur cases with type .1b HCV infection was different among different clinical types. The difference was statistically significant (P 0.05). The proportion of 1b type in hepatitis C associated liver cancer was higher. The average RNA load of 83.33 and 1.1b was 1.41 脳 10 ~ 6 卤1.43 脳 10 ~ 5 / ml. The average RNA load of type 2a was 7.84 脳 10 ~ 5 卤1.43 脳 10 ~ 5 / ml. The difference was statistically significant (P 0.05). The load levels were 1.00 脳 10 ~ (4) ~ 9.99 脳 10 ~ (4) and 1.00 脳 10 ~ (7) ~ 9.99 脳 10 ~ (7), respectively, at 1 b. There was significant difference between type 2a and other types, and the difference was statistically significant (P0.050.Conclusion: 1b genotype was predominant in 652 cases of HCV infection in Xinjiang, followed by 2a type 1b. 2a was different in hepatitis C patients of Han, Uygur and Kazakh nationalities, and the ethnic distribution of Xinjiang was different from that of other inland cities in the north. This may be one of the reasons why the genotype distribution of HCV is not consistent with the epidemiological characteristics reported in the past. The difference of 1b / 2a) in male and female was not different in all genotypes, but according to sex stratification statistics, the results showed that the male and female infected with hepatitis C were in 2a / 2a / 2a respectively in Chinese and Chinese. The composition ratio of Kazakh nationality is different from that of the three ethnic groups. This difference may be related to the living habits and educational level of the three ethnic groups. The difference between the rich and the poor and the race genotype and other factors related to the damage of liver caused by type 1 b HCV was much more serious than that of other subtypes. It is very important to understand the regional distribution of HCV genotyping. It is very important to understand the type C liver in Xinjiang. The HCV genotyping of patients with inflammation provides important information. At the same time, it provides valuable resources for the epidemiological study of hepatitis C, to judge the condition and prognosis and to observe the antiviral effect.
【学位授予单位】：新疆医科大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R512.63

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