云南大理地区丙型肝炎病毒基因分型及合并HIV感染后血细胞和生化指标变化的研究
发布时间：2018-07-17 02:21
【摘要】：目的 首先对2008年采集自大理州人民医院13例HIV合并丙型肝炎患者进行丙型肝炎病毒(HCV)基因分型研究,为丙型病毒性肝炎诊断、治疗、预后以及追溯传染源和传播途径的提供科学基础；其次对大理地区单纯性HCV感染和HCV合并HIV感染患者血细胞和生化指标进行分析,为单纯性HCV感染和合并HIV感染患者的诊断和治疗提供依据。 方法 采用型特异性引物进行巢式RT-PCR扩增,PCR产物直接测序,采用生物信息学软件进行序列分析；收集2013年1月-9月期间就诊于大理州人民医院门诊和住院临床诊断为单纯性HCV感染病例、HCV合并HIV感染病例以及排除HCV和HIV感染病例的基本信息、血细胞和血生化检测结果,采用SPSS17.0统计软件包中方差分析方法对血细胞和血生化检测结果进行统计分析,用卡方检验方法对病例基本信息进行统计分析。 结果 1、大理地区丙型肝炎病毒基因分型 收集到疑似丙型肝炎病人血清13份,核酸检测24、25、26、27总计4份标本阳性；序列分析结果显示,4株病毒之间核苷酸同源性在80.4%-95.8%之间：24与1b型病毒核苷酸同源性最高在98.6%以上,而其他基因型病毒核苷酸同源性在90.2以下；25、27与3b型病毒核苷酸同源性在92.1%-98.6%之间,而与其他基因型核苷酸同源性均在87.4%以下；26与3a型病毒核苷酸同源性较高在94.4%-94.9%之间,而与其他基因型病毒核昔酸同源性在84.6%以下。遗传进化分析结果显示25、27两型为3b丙型肝炎病毒感染者；26病例为3a丙型肝炎病毒感染者；24为lb丙型肝炎病毒感染者。 2、单纯性HCV感染与HCV合并HIV感染病人血常规和生化指标比较分析结果 在大理州人民医院共收集了107例病例信息,其中单纯性HCV感染病例32例、合并HIV感染病例45例、排除HCV和HIV病例30例。三组中性别比例(男：女)分别为4.33:1、8：1和6.5：1,经卡方检验X2=0.922,P=0.6310.05,表明各组之间不存在明显的性别差异；采用方差分析的统计方法经SPSS17.0统计软件包对三组病例的血细胞和生化检测结果进行统计分析,结果显示单纯性HCV感染病例、合并HIV感染病例和排除HCV和HIV感染病例三组病例组的WBC、RBC、 HGB、 PLT和HCT均有统计学差异(WBC:F=18.75,p=00.01; RBC:F=39.23, p=00.01; HGB:F=25.183, p=00.01; PLT:F=19.64, p=00.01; HCT:F=27.96, p=00.01),进一步两两比较来看,HCV合并HIV感染病例组WBC、 RBC、 HGB、 PLT和HCT均低于单纯性HCV感染组和对照组(P0.05)；单纯性HCV感染组除了WBC与对照组无统计学差异外,其它4个血细胞检测指标RBC、 HGB、 PLT和HCT均有不同程度降低(P0.05)；在TBIL、 TP、 ALB、 ALT、 AST、AKP、GGT和TBA等8项肝功能检测指标中,ALB、 ALT、 AST、 AKP、 GGT和TBA等6项指标在单纯性HCV感染病例、合并HIV感染病例和排除HCV和HIV感染病例三组间均有统计学差异(ALB:F=3.54, p=0.0340.05; ALT:F=5.71, p=0.0050.01; AST:F=7.29, p=0.0010.01; AKP:F=10.76,p=0.0000.01; GGT:F=8.154, p=0.001＜0.01; TBA:F=8.532, p=0.0000.01),而TBIL、 TP两项指标在三组间无统计学意义(TBIL:F=0.356, p=0.7010.05); TP:F=0.13, p=0.8780.05)。进一步两两比较来看,单纯性HCV感染组的ALT、 AST、 AKP、 GGT和TBA等5项肝功能指标较对照组均有不同程度升高(P0.05),而合并HIV感染病例组有ALB、 AKP、 GGT和TBA等4项肝功能指标较对照组升高(P0.05),ALT和AST在单纯性HCV感染组较HCV合并HIV感染病例组升高(P0.05)；HCV合并HIV感染病例组和单纯性HCV感染组TBA较对照组均升高(P0.05),但以HCV合并HIV感染病例组升高更为明显(P0.05)；在BUN、 CREA、 K+、Na+、Cl和Ca++等6项肾功能和电解质检测指标分析中,仅有K和Ca等2项指标在单纯性HCV感染病例、合并HIV感染病例和排除HCV和HIV感染病例三组间均有统计学差异(K:F=5.56, p=0.0060.01; Ca:F=11.786, p=0.0000.01),而其余的BUN. CREA, Na和C1等4项指标在三组间无统计学意义(BUN:F=0.331,p=0.7190.05; CREA: F=0.882,p=0.4190.05; Na:F=0.205, p=0.8150.05; Cl:F=1.182, p=0.3120.05)。进一步对K和Ca进行两两比较,单纯性HCV感染组K较对照组和HCV合并HIV感染组均明显下降(P0.05),HCV合并HIV感染组较对照组下降不明显(P0.05)；单纯性HCV感染组和HCV合并HIV感染组的Ca较对照组有不同程度的下降,但是单纯性HCV感染组与HCV合并HIV感染组的Ca相比较无明显下降(P0.05)。 结论 云南省大理地区HCV感染人群中存在基因1和基因3两个基因型,即3a、3b和1b三个基因亚型HCV病毒流行。 HCV感染后会使病人RBC、HGB、 PLT、 HCT、 K+离子和Ca++离子水平明显降低,ALT、 AST、AKP、 GGT和TBA水平明显升高：而合并HIV感染后不仅加重了RBC、HGB、PLT和HCT这四项指标严重下降,而且也使WBC水平明显降低,TBA水平却升高更为明显,提示了HCV合并HIV感染加重HCV的病程和疾病的严重程度。
[Abstract]:objective
First of all, the hepatitis C virus (HCV) genotyping of hepatitis C virus (HCV) was studied in 13 cases of HIV combined with hepatitis C in Dali People's Hospital in 2008, providing a scientific basis for the diagnosis, treatment, prognosis, and tracing the source and route of transmission of hepatitis C virus, followed by the simple HCV infection in Dali and the blood of HCV with HIV infected patients. Cell and biochemical indicators were analyzed to provide evidence for diagnosis and treatment of simple HCV infection and HIV infection.
Method
Type specific primers were used for nested RT-PCR amplification, direct sequencing of PCR products and sequence analysis by bioinformatics software. The clinical diagnosis of simple HCV infection cases in outpatient and hospitalization in Dali People's Hospital during the month of -9 in January 2013, HCV with HIV infection cases and the basic elimination of HCV and HIV infection cases were collected. Information, blood cells and blood biochemical test results were analyzed by the method of variance analysis in SPSS17.0 software package. The results of blood cell and blood biochemical detection were statistically analyzed, and the basic information of the cases was statistically analyzed with chi square test.
Result
1, hepatitis C virus genotyping in Dali
13 serum samples of patients with suspected hepatitis C were collected and 4 samples of 24,25,26,27 were positive. Sequence analysis showed that the nucleotide homology between 4 viruses was between 80.4%-95.8%: 24 and 1b virus nucleotide homology above 98.6%, while other genotype virus nucleotide homology was less than 90.2; 25,27 and 3b The nucleotide homology of the viral nucleotides is between 92.1%-98.6%, and the homology of the other genotype nucleotides below 87.4%; 26 with 3A virus nucleotides is higher in 94.4%-94.9% than in the other genotypes of the virus, and the homology is below 84.6%. The genetic evolution analysis results show that the 25,27 type two is 3B hepatitis C virus infection Among them, 26 were 3A hepatitis C virus infection and 24 were LB hepatitis C virus infection.
2, comparative analysis of blood routine and biochemical indexes between simple HCV infection and HCV combined with HIV infection.
In Dali People's Hospital, 107 cases of case information were collected, including 32 cases of simple HCV infection, 45 cases of HIV infection and 30 cases of exclusion of HCV and HIV. The three groups (male: female) were 4.33:1,8:1 and 6.5:1 respectively, and X2=0.922 and P=0.6310.05 were tested by chi square, indicating that there was no obvious gender difference between each group. The statistical method of variance analysis was used to analyze the blood cell and biochemical test results of three groups of cases by SPSS17.0 statistical software package. The results showed that the cases of simple HCV infection, the combination of HIV infection cases and the WBC of three groups of cases excluding HCV and HIV infection cases, RBC, HGB, PLT and HCT were statistically different (WBC:F=18.75, p=00.01; p=00.01; F=39.23, p=00.01; HGB:F=25.183, p=00.01; PLT:F=19.64, p=00.01; HCT:F=27.96, p=00.01). In the further 22 comparison, HCV combined with HIV infection case group was lower than that of the simple infection group and the control group; the other 4 blood cells, except for the control group, were not statistically different from those of the control group. The detection indexes, RBC, HGB, PLT and HCT were reduced in varying degrees (P0.05), and there were 6 indexes in 8 liver function tests, such as TBIL, TP, ALB, ALT, AST, AKP, GGT, etc. P=0.0340.05; ALT:F=5.71, p=0.0050.01; AST:F=7.29, p=0.0010.01; AKP:F=10.76, p=0.0000.01; GGT:F=8.154, p=0.001 < 0.01; TBA:F=8.532, p=0.0000.01), and TBIL, there is no statistical significance between the three groups. Further 22 comparison, simple infection infection The 5 liver function indexes, such as ALT, AST, AKP, GGT and TBA, were higher than the control group (P0.05), but there were ALB, AKP, GGT and TBA in the case group with HIV infection, which was higher than the control group (P0.05). The increase of TBA in the HCV infection group was higher than that in the control group (P0.05), but the increase in the HCV combined with HIV infection group was more obvious (P0.05). In the analysis of 6 renal function and electrolyte detection indexes, such as BUN, CREA, K+, Na+, Cl and Ca++, the only 2 indexes were the cases of simple infection and the exclusion and infection of the infection cases. There were statistical differences between the three groups (K:F=5.56, p=0.0060.01; Ca:F=11.786, p=0.0000.01), while the rest of the BUN. CREA, Na and C1 were not statistically significant between the three groups (BUN:F=0.331, p=0.7190.05; CREA: F=0.882). Compared with the control group and the HIV infection group, the pure HCV infection group decreased significantly (P0.05), and the HCV combined with HIV infection group was not significantly lower than the control group (P0.05). The Ca group and the HCV combined HIV infection group had different degrees of decline, but there was no significant difference between the simple HCV infection group and the HCV combined HIV infection group. Drop (P0.05).
conclusion
There are 1 genotypes of HCV and 3 genotypes of two genes in the Dali area of Yunnan Province, namely, 3a, 3b and 1b, and the three subtypes of HCV virus are prevalent.
After HCV infection, the levels of RBC, HGB, PLT, HCT, K+ and Ca++ ions were significantly reduced, ALT, AST, AKP, GGT and TBA levels were significantly increased. Dyed the course of the HCV and the severity of the disease.
【学位授予单位】：昆明医科大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R512.63
本文编号：2128590
[Abstract]:objective
First of all, the hepatitis C virus (HCV) genotyping of hepatitis C virus (HCV) was studied in 13 cases of HIV combined with hepatitis C in Dali People's Hospital in 2008, providing a scientific basis for the diagnosis, treatment, prognosis, and tracing the source and route of transmission of hepatitis C virus, followed by the simple HCV infection in Dali and the blood of HCV with HIV infected patients. Cell and biochemical indicators were analyzed to provide evidence for diagnosis and treatment of simple HCV infection and HIV infection.
Method
Type specific primers were used for nested RT-PCR amplification, direct sequencing of PCR products and sequence analysis by bioinformatics software. The clinical diagnosis of simple HCV infection cases in outpatient and hospitalization in Dali People's Hospital during the month of -9 in January 2013, HCV with HIV infection cases and the basic elimination of HCV and HIV infection cases were collected. Information, blood cells and blood biochemical test results were analyzed by the method of variance analysis in SPSS17.0 software package. The results of blood cell and blood biochemical detection were statistically analyzed, and the basic information of the cases was statistically analyzed with chi square test.
Result
1, hepatitis C virus genotyping in Dali
13 serum samples of patients with suspected hepatitis C were collected and 4 samples of 24,25,26,27 were positive. Sequence analysis showed that the nucleotide homology between 4 viruses was between 80.4%-95.8%: 24 and 1b virus nucleotide homology above 98.6%, while other genotype virus nucleotide homology was less than 90.2; 25,27 and 3b The nucleotide homology of the viral nucleotides is between 92.1%-98.6%, and the homology of the other genotype nucleotides below 87.4%; 26 with 3A virus nucleotides is higher in 94.4%-94.9% than in the other genotypes of the virus, and the homology is below 84.6%. The genetic evolution analysis results show that the 25,27 type two is 3B hepatitis C virus infection Among them, 26 were 3A hepatitis C virus infection and 24 were LB hepatitis C virus infection.
2, comparative analysis of blood routine and biochemical indexes between simple HCV infection and HCV combined with HIV infection.
In Dali People's Hospital, 107 cases of case information were collected, including 32 cases of simple HCV infection, 45 cases of HIV infection and 30 cases of exclusion of HCV and HIV. The three groups (male: female) were 4.33:1,8:1 and 6.5:1 respectively, and X2=0.922 and P=0.6310.05 were tested by chi square, indicating that there was no obvious gender difference between each group. The statistical method of variance analysis was used to analyze the blood cell and biochemical test results of three groups of cases by SPSS17.0 statistical software package. The results showed that the cases of simple HCV infection, the combination of HIV infection cases and the WBC of three groups of cases excluding HCV and HIV infection cases, RBC, HGB, PLT and HCT were statistically different (WBC:F=18.75, p=00.01; p=00.01; F=39.23, p=00.01; HGB:F=25.183, p=00.01; PLT:F=19.64, p=00.01; HCT:F=27.96, p=00.01). In the further 22 comparison, HCV combined with HIV infection case group was lower than that of the simple infection group and the control group; the other 4 blood cells, except for the control group, were not statistically different from those of the control group. The detection indexes, RBC, HGB, PLT and HCT were reduced in varying degrees (P0.05), and there were 6 indexes in 8 liver function tests, such as TBIL, TP, ALB, ALT, AST, AKP, GGT, etc. P=0.0340.05; ALT:F=5.71, p=0.0050.01; AST:F=7.29, p=0.0010.01; AKP:F=10.76, p=0.0000.01; GGT:F=8.154, p=0.001 < 0.01; TBA:F=8.532, p=0.0000.01), and TBIL, there is no statistical significance between the three groups. Further 22 comparison, simple infection infection The 5 liver function indexes, such as ALT, AST, AKP, GGT and TBA, were higher than the control group (P0.05), but there were ALB, AKP, GGT and TBA in the case group with HIV infection, which was higher than the control group (P0.05). The increase of TBA in the HCV infection group was higher than that in the control group (P0.05), but the increase in the HCV combined with HIV infection group was more obvious (P0.05). In the analysis of 6 renal function and electrolyte detection indexes, such as BUN, CREA, K+, Na+, Cl and Ca++, the only 2 indexes were the cases of simple infection and the exclusion and infection of the infection cases. There were statistical differences between the three groups (K:F=5.56, p=0.0060.01; Ca:F=11.786, p=0.0000.01), while the rest of the BUN. CREA, Na and C1 were not statistically significant between the three groups (BUN:F=0.331, p=0.7190.05; CREA: F=0.882). Compared with the control group and the HIV infection group, the pure HCV infection group decreased significantly (P0.05), and the HCV combined with HIV infection group was not significantly lower than the control group (P0.05). The Ca group and the HCV combined HIV infection group had different degrees of decline, but there was no significant difference between the simple HCV infection group and the HCV combined HIV infection group. Drop (P0.05).
conclusion
There are 1 genotypes of HCV and 3 genotypes of two genes in the Dali area of Yunnan Province, namely, 3a, 3b and 1b, and the three subtypes of HCV virus are prevalent.
After HCV infection, the levels of RBC, HGB, PLT, HCT, K+ and Ca++ ions were significantly reduced, ALT, AST, AKP, GGT and TBA levels were significantly increased. Dyed the course of the HCV and the severity of the disease.
【学位授予单位】：昆明医科大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R512.63
【参考文献】
相关期刊论文 前10条
1 胡志军;丁辉;汪晓军;;69例慢性丙型肝炎患者基因型与肝功能指标、HCV RNA及中医证型的相关性分析[J];北京中医药;2012年03期
2 王敏;周源;陈帆;王怡仲;许茹;夏文杰;聂咏梅;花文峰;付涌水;;云南和山西无偿献血人群HCV部分基因的核苷酸序列测定及基因分型[J];中国输血杂志;2009年11期
3 解莹;谢晨;;丙型肝炎病毒基因分型的研究进展[J];大连医科大学学报;2010年04期
4 李磊;樊和斌;杨东亮;;亚太肝病研究学会丙型肝炎病毒感染的诊断与治疗共识[J];实用肝脏病杂志;2007年05期
5 李峥;高玉红;毕胜;杨曦;张桂前;台虹;;云南省丙型肝炎病毒基因型及3b型遗传进化树分析[J];国际检验医学杂志;2006年11期
6 戚应杰;岳莉;朱义媛;陈苓;;丙型肝炎患者病毒载量与ALT、AST的相关性研究[J];国际检验医学杂志;2012年09期
7 苏英豪;;丙型肝炎病毒基因分型及其意义:近3年的研究进展[J];国外医学(微生物学分册);1999年01期
8 刘兴辉;;丙型肝炎患者PTA、CHE、D-D检测的临床意义[J];国际检验医学杂志;2012年15期
9 杨伟国;徐辉;;甘肃省4个不同民族丙型肝炎病毒感染的基因型特征[J];甘肃中医学院学报;2013年01期
10 赵金仙;陈良;许杰;鲁建波;蔡英;陈黎跃;;云南省玉溪地区吸毒人群人类免疫缺陷病毒、丙型肝炎病毒、梅毒螺旋体感染状况及行为学调查[J];疾病监测;2008年09期
相关博士学位论文 前1条
1 赵文华;云南省丙型肝炎病毒分子流行病学研究及其遗传多样性分析[D];中国协和医科大学;2008年
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