儿童接种乙肝疫苗后乙肝表面抗体质和量的变化与HLA-DQB1多态性关联以及其它影响因素

发布时间：2018-02-10 04:20

本文关键词： HLA-DQB1 乙肝表面抗体抗体亲和力年龄　出处：《大连医科大学》2017年硕士论文　论文类型：学位论文

【摘要】：目的:观察不同年龄人群乙肝表面抗体阳性率的差异,寻找HLA多态性与乙肝表面抗体水平的相关性。并利用对三个不同年龄组的乙肝表面抗体阳性的患者的抗体总活性、抗体亲和力之间的比较,及抗体总活性和抗体亲和力与血清生化指标之间的关系,来找出影响乙肝表面抗体水平的因素。方法:本实验血清样本来自大连医大学附属第一医院和大连市儿童医院的患者(乙肝表面抗体阳性,乙肝表面抗原阴性,乙肝核心抗体阴性,乙肝e抗体阴性,乙肝e抗原阴性),选取200例血清样本,其中男性100例,女性100例。按年龄将样本分为四个组:1-2岁组,男女各25例;6-8岁组,男女各25例;24-26岁组,男女各25例。6-8岁组乙肝表面抗体阴性对照组男女各25例。首先对6-8岁组的HLA-DQB1基因分型进行检测。用LIASON全自动化学发光分析仪对乙肝表面抗体阳性的血清进行一定比例的连续稀释后检测,直到检测稀释样本为阴性为止,经线性转化求得总活性和亲和力。利用日立7180全自动生化分析仪对四组血清进行生化项目检测。找出抗体总活性和抗体亲和力与生化指标之间的相关性。另选取70例血清样本,进行乙肝表面抗体中和表面抗原试验,其中成年组(乙肝表面抗体阳性,乙肝表面抗原阴性,乙肝核心抗体阳性,乙肝e抗体阳性,乙肝e抗原阴性)35例,儿童组(乙肝表面抗体阳性,乙肝表面抗原阴性,乙肝核心抗体阴性,乙肝e抗体阴性,乙肝e抗原阴性)35例。结果:HLA-DQB1多态性与乙肝表面抗体水平无统计学关系。1-2岁乙肝表面抗体总活性与铁蛋白,天门冬氨酸氨基转移酶,血清总蛋白,血清白蛋白,血清尿酸,血清尿素氮,血清钙离子,血清镁离子,胱抑素C均有相关性。1-2岁乙肝表面抗体总活性与血清谷丙氨酸氨转移酶,血糖,肌酐,磷,NT-proBNP无相关。1-2岁组抗体亲和力与血清谷丙氨酸氨转移酶,天门冬氨酸基转移酶有相关性。1-2岁组抗体亲和力与总蛋白,白蛋白,尿酸,血糖,尿素氮,肌酐,钙,镁,磷,胱抑素C,铁蛋白,NT-proBNP无相关。6-8岁年龄组总活性与血清尿素氮,血清胱抑素C有相关性。6-8岁年龄组总活性与谷丙氨酸,天门冬氨酸,总蛋白,白蛋白,尿酸,血糖,肌酐,钙,镁,磷,铁蛋白,NT-proBNP无相关。6-8年龄组亲和力与血清谷丙氨酸氨基转移酶,总蛋白,血糖,血尿素氮,血肌酐,血磷均有相关性。6-8年龄组亲和力与谷丙氨酸,天门冬氨酸,白蛋白,尿酸,钙,镁,胱抑素C,铁蛋白,NT-proBNP无相关性。24-26岁组总活性与血清白蛋白,血清钙离子有相关性。6-8岁乙肝表面抗体阳性与阴性组血清尿酸,磷,白细胞是影响抗体产生因素。乙肝恢复期成人和健康儿童乙肝表面抗体活性存在显著性差异。结论:同一水平的疫苗诱发的表面抗体的中和作用不及自然感染人群所产生的表面抗体,在不同年龄儿童中乙肝表面抗体阳性率和总活性也有所不同,可能和不同年龄的生理,营养和发育有关。
[Abstract]:Objective: to observe the difference of positive rate of hepatitis B surface antibody in different age groups, to find out the correlation between HLA polymorphism and hepatitis B surface antibody level, and to make use of the total antibody activity of three different age groups of patients with positive hepatitis B surface antibody. The comparison of antibody affinity and the relationship between total antibody activity, antibody affinity and serum biochemical indexes, Methods: the serum samples were collected from patients from the first affiliated Hospital of Dalian Medical University and Dalian Children's Hospital. Hepatitis B core antibody negative, hepatitis B e antibody negative, hepatitis B e antigen negative, 200 serum samples were selected, including 100 males and 100 females. According to their age, the samples were divided into four groups: 1 to 2 years old, 25 male and 25 male to 8 years old. 25 men and 25 women aged 24 to 26, There were 25 cases in male and 25 cases in group of 6-8 years old and 25 cases in negative control group. The HLA-DQB1 genotyping of group 6-8 years old was detected. LIASON automatic chemiluminescence analyzer was used to detect the positive serum of anti-HBV surface antibody. Ratio of continuous dilution after detection, Until the diluted sample is negative, The total activity and affinity were obtained by linear transformation. The biochemical items of four groups of serum were tested by Hitachi 7180 automatic biochemical analyzer. The correlation between the total activity of antibody and the affinity of antibody and biochemical index was found out. 70 serum samples were selected. The neutralizing surface antigen test of hepatitis B surface antibody was carried out. In adult group, 35 cases were positive for hepatitis B surface antibody, negative for hepatitis B surface antigen, positive for hepatitis B core antibody, positive for hepatitis B e antibody, and negative for hepatitis B e antigen. Children's group (hepatitis B surface antibody positive, hepatitis B surface antigen negative, hepatitis B core antibody negative, hepatitis B e antibody negative, Results there was no significant correlation between HLA-DQB1 polymorphism and HBV surface antibody level. Total activity of HBV surface antibody and ferritin, aspartate aminotransferase, serum total protein, serum albumin, serum uric acid in 1-2 years old were not significantly correlated with HLA-DQB1 polymorphism. Serum urea nitrogen, serum calcium ion, serum magnesium ion, cystatin C were all correlated. Total activity of hepatitis B surface antibody in 1-2 years old was correlated with serum glutamic alanine aminotransferase, blood glucose, creatinine. The antibody affinity of NT-proBNP was not correlated with serum glutamic alanine aminotransferase, aspartate aminotransferase was correlated with serum aspartate aminotransferase. In 1-2 years old group, antibody affinity was related to total protein, albumin, uric acid, blood glucose, urea nitrogen, creatinine, calcium, magnesium, phosphorus, The total activity of cystatin C, ferritin NT-proBNP was not correlated with serum urea nitrogen. The total activity of serum cystatin C was correlated with glutenin, aspartic acid, total protein, albumin, uric acid, blood glucose, creatinine, calcium, magnesium, and serum cystatin C, and the total activity of serum cystatin C was correlated with glutathione, aspartic acid, total protein, albumin, uric acid, blood glucose, creatinine, calcium, magnesium. The affinity of NT-proBNP was not correlated with serum glutamic alanine aminotransferase, total protein, blood glucose, blood urea nitrogen, serum creatinine and serum phosphorus. Uric acid, calcium, magnesium, cystatin C, ferritin NT-proBNP have no correlation. The total activity of NT-proBNP is correlated with serum albumin and serum calcium ion. WBC is the factor that affects antibody production. There is significant difference between adult and healthy children in hepatitis B surface antibody activity. Conclusion: the neutralization effect of surface antibody induced by the same level of vaccine is not as good as that of natural infection. The surface antibody produced by the group, The positive rate and total activity of HBsAg may be related to physiology, nutrition and development of children of different ages.
【学位授予单位】：大连医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R186

【相似文献】