本文選題：丙型肝炎 + 丙型肝炎病毒抗體��； 參考：《廣西醫(yī)科大學(xué)》2013年碩士論文

【摘要】：目的糖尿病是我國(guó)常見的慢性代謝性疾病之一,其病程長(zhǎng),并發(fā)癥多,嚴(yán)重影響人們的身體健康和生活質(zhì)量。本研究通過調(diào)查2型糖尿病患者中丙型肝炎病毒抗體(抗-HCV)的流行情況及丙型肝炎病毒基因型的分布情況,探索丙型肝炎感染是否為2型糖尿病發(fā)病的危險(xiǎn)因素以及2型糖尿病發(fā)病是否與丙型肝炎病毒的基因分型有關(guān),為今后糖尿病的防治提供科學(xué)依據(jù)。 方法1、2012年3月-5月,從廣西醫(yī)科大學(xué)第一附屬醫(yī)院收集2型糖尿病者710例,同期在該院收集對(duì)照者696例。采用統(tǒng)一的問卷對(duì)納入研究者進(jìn)行相關(guān)方面的資料收集,同時(shí)對(duì)所有納入研究的對(duì)象使用一次性采血針及真空管采集靜脈血5mL,將血樣以3000r/min離心10分鐘后分離血清,取上清,血清標(biāo)本存放-80℃冰箱備檢。 2、采用酶聯(lián)免疫法對(duì)2型糖尿病者和對(duì)照者的血清進(jìn)行抗-HCV檢測(cè)和乙肝病毒表面抗原(HBsAg)檢測(cè),并將兩者的陽(yáng)性率及性別分層進(jìn)行比較。 3、用相關(guān)試劑對(duì)抗-HCV呈陽(yáng)性的血清標(biāo)本進(jìn)行病毒RNA的提取,逆轉(zhuǎn)錄成cDNA,然后用巢式PCR的方法進(jìn)行HCV RNA的檢測(cè)。 4、將PCR產(chǎn)物送檢測(cè),根據(jù)每個(gè)樣本的測(cè)序結(jié)果用Blast軟件比對(duì)分析序列,確�；蚍中偷臏�(zhǔn)確性,進(jìn)行HCV基因分型。 5、對(duì)所有數(shù)據(jù)進(jìn)行錄入,建立數(shù)據(jù)庫(kù),采用SPSS13.0分析軟件進(jìn)行數(shù)據(jù)處理,率的比較用χ2檢驗(yàn),兩組均數(shù)的比較用t檢驗(yàn),以P0.05為差異有統(tǒng)計(jì)學(xué)意義。 結(jié)果1、2型糖尿病患者與對(duì)照者性別、年齡均數(shù)和乙型肝炎感染方面均衡可比。2型糖尿病患者組710例,男383例,女327例。對(duì)照組696例,其中男384例,女312例。兩組之間性別構(gòu)成差異無統(tǒng)計(jì)學(xué)意義(χ2=0.214,P0.05)。兩組年齡均數(shù)差異無統(tǒng)計(jì)學(xué)意義(t=1.277,P0.05)。兩組乙型肝炎表面抗原陽(yáng)性率差異無統(tǒng)計(jì)學(xué)意義(χ2=0.764,P0.05)。 2、2型糖尿病組的抗-HCV陽(yáng)性率(3.10%)明顯高于對(duì)照組的陽(yáng)性率(1.29%),兩者的差異有統(tǒng)計(jì)學(xué)意義(χ2=5.313,P0.05)。但在所有年齡組中,只有60-69歲年齡組中兩者的差異有統(tǒng)計(jì)學(xué)意義(χ2=6.891,P0.01),其他年齡組差異無統(tǒng)計(jì)學(xué)意義。 3、2型糖尿病組與對(duì)照組之間比值比(OR)為2.44,表明HCV感染將使2型糖尿病發(fā)病危險(xiǎn)性增加2.44倍左右(95%可信區(qū)間為1.14-5.21)。 4、病例組22例抗-HCV陽(yáng)性者中,男11例,女11例。對(duì)照組9例抗-HCV陽(yáng)性者中,男4例,女5例,采用逆轉(zhuǎn)錄巢式PCR對(duì)這31例樣本進(jìn)行檢測(cè),HCV RNA呈陽(yáng)性24例,占77.42%(24/31),其中病例組的為19例,占86.36%(19/22)。對(duì)照組5例,占55.56%(5/9),兩者差異無統(tǒng)計(jì)學(xué)意義(P0.05)。 5、根據(jù)序列比對(duì)結(jié)果,我們得出24例HCV RNA陽(yáng)性的標(biāo)本中,1b型21例,占87.5%(21/24)。2a型3例,占12.5%(3/24),未見混合型。本研究中,病例組HCV RNA陽(yáng)性19例,其中1b型16例,2a型3例。對(duì)照組中,HCV RNA陽(yáng)性5例,其中1b型5例,未檢出2a型。 6、在24例HCV基因分型中,2型糖尿病組19例,其中l(wèi)b型16例,1b型陽(yáng)性率為2.25%(16/710)。2a型3例,2a型陽(yáng)性率為0.42%(3/710)。對(duì)照組5例,其全部為lb型,陽(yáng)性率為0.72%(5/696)。糖尿病組1b型的陽(yáng)性率與對(duì)照組陽(yáng)性率差異有統(tǒng)計(jì)學(xué)意義(χ2=5.630,P0.05)。在各年齡段病例組與對(duì)照組1b基因型陽(yáng)性率比較中,60-69歲年齡段兩者差異有統(tǒng)計(jì)學(xué)意義(χ2=4.503,P0.05),其他年齡段差異無統(tǒng)計(jì)學(xué)意義(P0.05)。 結(jié)論1、2型糖尿病患者丙型肝炎病毒的感染率高于普通人群,乙型肝炎病毒表面抗原陽(yáng)性率與普通人群無差異,提示丙型肝炎病毒感染可能是2型糖尿病發(fā)病的危險(xiǎn)因子。 2、根據(jù)丙型肝炎病毒的基因分型結(jié)果,廣西地區(qū)HCV流行主要為1b型和2a型。 3、糖尿病患者中1b型的陽(yáng)性率高于普通人群,尤其是60-69歲年齡段風(fēng)險(xiǎn)最高。推測(cè)可能HCV1b型更容易合并糖尿病的發(fā)生。
[Abstract]:Objective diabetes is one of the common chronic metabolic diseases in China. It has a long course and many complications, which seriously affect the health and quality of life of the people. In this study, the prevalence of hepatitis C virus antibody (anti -HCV) and the distribution of hepatitis C virus genotype in type 2 diabetes patients were investigated and the infection of hepatitis C infection was explored. Whether or not the risk factors for the onset of type 2 diabetes and whether the onset of type 2 diabetes is related to the genotyping of HCV, provides a scientific basis for the prevention and treatment of diabetes in the future.
Methods 710 cases of type 2 diabetes were collected from the First Affiliated Hospital of Guangxi Medical University in March 12012. 696 cases of control were collected at the same period in the same period. A unified questionnaire was used to collect data on the related subjects. At the same time, all the subjects were collected with a single blood collection needle and vacuum tube to collect the venous blood 5mL. Blood samples were centrifuged for 10 minutes after 3000r/min centrifugation. Serum samples were collected from Torikami Kiyo. Serum samples were stored at -80 C refrigerator for preparation.
2, anti -HCV detection and hepatitis B virus surface antigen (HBsAg) were detected by enzyme linked immunosorbent assay (ELISA) in the serum of type 2 diabetes and control, and the positive rate and gender stratification were compared.
3, using related reagents to extract RNA from -HCV positive serum samples, reverse transcription into cDNA, and then detect HCV RNA by nested PCR.
4, the PCR products were sent to the test. According to the sequencing results of each sample, the sequence of Blast software was used to compare and analyze the sequence, so as to ensure the accuracy of genotyping and HCV genotyping.
5, all the data were recorded, the database was established, and the SPSS13.0 analysis software was used to process the data. The ratio of the rate was compared with the x 2 test. The comparison of the average number of the two groups was tested by T, and the difference was statistically significant with the difference of P0.05.
Results the balance of sex, age and hepatitis B infection in type 1,2 diabetes patients was 710 cases of type.2 diabetes, 383 men and 327 women. 696 cases in the control group, including 384 men and 312 women. There was no statistical difference between the two groups (x 2= 0.214, P0.05). There was no statistical difference between the two groups (t 0.214, P0.05). =1.277, P0.05). There was no significant difference in the positive rate of HBsAg between the two groups (chi 2=0.764, P0.05).
The positive rate of anti -HCV in type 2,2 diabetes group (3.10%) was significantly higher than that of the control group (1.29%). The difference between the two groups was statistically significant (x 2=5.313, P0.05). But in all age groups, the difference between the two groups was statistically significant (x 2=6.891, P0.01), and there was no statistical difference in the other age groups.
The ratio Ratio (OR) between the type 3,2 diabetes group and the control group was 2.44, indicating that HCV infection would increase the risk of type 2 diabetes by 2.44 times (95% confidence interval 1.14-5.21).
4, among the 22 cases of anti -HCV positive cases in the case group, 11 cases were male and 11 women. 9 cases of anti -HCV positive in the control group, 4 men and 5 women, the 31 samples were detected by the reverse transcription nested PCR, and HCV RNA was positive in 24 cases, accounting for 77.42% (24/31), including 19 cases in the case group, accounting for 86.36% (19/22). The control group was 9 (5/9). The difference was not statistically significant. (P0.05).
5, according to the sequence alignment results, we obtained 24 cases of HCV RNA positive, 21 cases of 1B type, 87.5% (21/24).2a type 3 cases, 12.5% (3/24), no mixed type. In this study, 19 cases of HCV RNA positive in the case group, 1b type 16, 2A type 3, 5 cases of HCV RNA, 5 cases, not detected type.
6, in 24 cases of HCV genotyping, 19 cases of type 2 diabetes, of which 16 cases were lb, 3 cases of type 1b positive, 2.25% (16/710).2a, 2 a positive rate was 0.42% (3/710). 5 cases in the control group were LB type, the positive rate was 0.72% (5/696). The difference between the positive rate of the 1b type in the diabetic group and the control group was statistically significant (x 2=5.630, P0.05). In every year, the positive rate was statistically significant (x 2=5.630, P0.05). The difference in the positive rate of 1B genotype between the age group and the control group was statistically significant (x 2=4.503, P0.05), and there was no significant difference in the other age groups (P0.05) in the age group of the age group and the control group.
Conclusion the infection rate of hepatitis C virus in patients with type 1,2 diabetes is higher than that of the general population. There is no difference between the positive rate of HBsAg and the general population, suggesting that HCV infection may be a risk factor for the onset of type 2 diabetes.
2, according to the genotype of HCV, the prevalence of HCV in Guangxi is mainly 1b and 2A.
3, the positive rate of type 1B in diabetic patients is higher than that in the general population, especially in the 60-69 year old age group. It is speculated that HCV1 B is more likely to be associated with diabetes mellitus.

【學(xué)位授予單位】：廣西醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2013
【分類號(hào)】：R512.63;R587.1

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本文編號(hào)：1834048