青岛地区献血者戊型肝炎流行病学及血清学特征研究

发布时间：2018-02-01 14:14

本文关键词： 戊型肝炎 HEV 献血者输血传播　出处：《青岛大学》2017年硕士论文　论文类型：学位论文

【摘要】：研究背景戊型肝炎病毒(Hepatitis E Virus,HEV)是引起戊型肝炎发病的病原体,主要在卫生条件差的地区经粪-口途径传播。HEV输血感染在日本和英国已经得到了证实,HEV经输血途径传播已成为一个严重的公共健康问题,受到国内外越来越多的关注。现阶段,HEV并未列入中国献血者常规筛查指标,关于青岛地区献血者HEV感染情况缺乏相关研究。研究目的通过对献血者进行调查,了解青岛地区无偿献血人群中戊型肝炎病毒的流行情况,分析输血传播HEV的潜在危险性,探讨谷丙转氨酶(ALT)水平与HEV感染的相关性,分析比较重叠感染的戊型肝炎的人群特点,为预防HEV通过输血途径传播提供参考。研究方法1、收集青岛地区献血者血样,其中包括合格献血者739例进行HEV的相关血清学指标检测(抗-HEV Ig G,抗-HEV Ig M,HEV Ag)并与833例单纯ALT升高组比较分析献血者HEV流行病学特点。2、收集乙肝感染献血者血样105份进行戊型肝炎病毒的相关血清学指标检测,与合格献血者比较分析HEV重叠感染的血清学特点。研究结果739名合格的无偿献血者中抗-HEV Ig G阳性95例,阳性率12.86%;抗-HEV Ig M阳性6例,阳性率为0.81%;HEV Ag阳性1例,阳性率为0.14%。833名ALT升高的献血者中抗-HEV Ig G阳性109例,阳性率13.09%;抗-HEV Ig M阳性7例,阳性率为0.84%;HEV Ag阳性1例,阳性率为0.12%。合格献血者抗-HEV Ig G和Ig M检出率与ALT升高者相比差异无统计学意义(p0.05)。40岁以上年龄段明显高于低年龄段比例(χ2=12.967,P0.01)。在739份合格献血者和833份单纯的ALT升高的献血者的血液中,有8例样本是HEV Ig G和Ig M同时阳性,195例样本是HEV Ig G单独阳性,5例样本是HEV Ig M单独阳性,2例标本为HEV抗原单独阳性。随机抽取的105例HBV感染患者中,HEV合并HBV感染患者20例,HBV感染者各年龄组的HEV Ig G阳性率均高于合格献血者。合格献血者和HBV感染者中HEV Ig G阳性率最高的职业都是农民。研究结论青岛地区是一个戊型肝炎流行地区,献血者中存在一定比例HEV感染者。ALT筛查对HEV的血液筛查作用不大,献血者经过常规血液筛查后,仍有输血传播HEV的潜在风险。
[Abstract]:Background Hepatitis E virus (HEV) is the pathogen causing hepatitis E. Transmission of HEV through faecal-oral route has been confirmed to be a serious public health problem in Japan and the United Kingdom, mainly in areas with poor sanitary conditions. More and more attention has been paid at home and abroad. At this stage, HEV is not included in the Chinese blood donors routine screening indicators. There is a lack of relevant research on HEV infection among blood donors in Qingdao. Objective to investigate the prevalence of hepatitis E virus among blood donors in Qingdao. To analyze the potential risk of transfusion-transmitted HEV, to explore the correlation between alt level and HEV infection, and to compare the population characteristics of hepatitis E with superinfection. In order to prevent the transmission of HEV through blood transfusion. 1. Collect blood samples from blood donors in Qingdao. Among them, 739 eligible blood donors were tested for the relative serological indexes of HEV (anti-HEV IgG, anti-HEV Ig M). The epidemiological characteristics of HEV in blood donors were compared with those in 833 patients with elevated ALT. 105 blood samples from patients with hepatitis B infection were collected for the detection of hepatitis E virus related serological indexes. The serological characteristics of HEV superinfection were compared with those of qualified blood donors. The results showed that 95 of 739 eligible blood donors were positive for anti-HEV Ig G, the positive rate was 12.86%. Anti-HEV IgG M was positive in 6 cases, the positive rate was 0.81%. One case was positive for HEV Ag, and the positive rate was 0.14%. 109 cases were positive for anti-HEV IgG, the positive rate was 13.09%. Anti-HEV IgG M was positive in 7 cases, the positive rate was 0.84%. HEV Ag was positive in 1 case. The positive rate of anti-HEV IgG and IgM in qualified blood donors was 0.12. There was no significant difference between the positive rates of anti-HEV IgG and IgM in patients with elevated ALT (p 0.05). The proportion of age group over 40 years old was significantly higher than that of low age group (蠂 2 + 12.967). In 739 eligible donors and 833 simple elevated ALT donors, 8 samples were positive for both HEV IgG and IgM. 195 samples were HEV IgG positive alone and 5 samples were HEV IgM positive. Two samples were single positive for HEV antigen, and 20 of 105 HBV infected patients with HBV infection were randomly selected. The positive rate of HEV Ig G in all age groups of HBV infected persons was higher than that in qualified blood donors. The highest positive rate of G was found in farmers. Conclusion Qingdao is an epidemic area of hepatitis E. There is a certain proportion of blood donors infected with HEV. Alt screening has little effect on the blood screening of HEV. After routine blood screening, donors still have the potential risk of blood transfusion transmission of HEV.
【学位授予单位】：青岛大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R512.6;R181.3

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