本文選題：CHC + PCR��； 參考：《安徽醫(yī)科大學(xué)》2014年碩士論文

【摘要】：目的本研究旨在探討人體外周靜脈血中T淋巴細(xì)胞亞群和谷丙轉(zhuǎn)氨酶(ALT)、谷草轉(zhuǎn)氨酶(AST)與慢性丙型肝炎(Chronic hepatitis C、CHC)患者丙型肝炎病毒(HCV)核糖核酸(RNA)復(fù)制程度的關(guān)系。方法搜集安徽醫(yī)科大學(xué)第一附屬醫(yī)院傳染病科2012年5月~2013年2月連續(xù)10個(gè)月內(nèi)門(mén)診及住院的CHC成年患者169例,同期120例正常健康者的EDTA-K2抗凝外周靜脈血1 ml和非抗凝外周靜脈血4 ml。采用流式細(xì)胞儀直接免疫熒光法對(duì)所搜集的病人外周抗凝靜脈血中的T細(xì)胞亞群進(jìn)行檢測(cè);利用熒光定量PCR法檢測(cè)成年患者及正常健康者的非抗凝血分離的血清中的丙型肝炎病毒核糖核酸(HCV RNA)的復(fù)制濃度。采用OLYMPUS640生化分析儀檢測(cè)ALT、AST的濃度結(jié)果①CHC患者CD4+T細(xì)胞百分率(42.87±6.11)及CD4+/CD8+比值(1.34±0.25)明顯低于正常健康者(49.55±6.68)和(1.82±0.11)(P0.01),而CD8+T細(xì)胞百分率(32.78±5.48)則高于正常健康者(27.35±4.32)(P0.01),CD3+T細(xì)胞百分率無(wú)差異(P0.05)。②熒光定量PCR法檢測(cè)CHC患者的結(jié)果為載量大于1.00×105 copies/ml,57例;載量在1.00×103~1.00×105 copies/ml,55例;載量小于1.00×103 copies/ml,57例;120例正常健康者載量均在0~1.0×103。通過(guò)檢測(cè)結(jié)果的統(tǒng)計(jì)學(xué)分析得知隨著HCV RNA復(fù)制載量的增加,CD8+T細(xì)胞百分率逐漸增加,而CD4+T細(xì)胞百分率及CD4+/CD8+比值逐漸降低。③載量大于1.00×103 copies/ml 112例標(biāo)本中有77例ALT異常,異常率68.7%,同時(shí)有70例AST異常,異常率62.5%,統(tǒng)計(jì)學(xué)分析ALT、AST異常隨著HCV-RNA含量的增加而升高,二者呈正相關(guān)系(r=0.871,P0.05)而ALT、AST濃度變化與HCV-RNA含量無(wú)相關(guān)性(r=0.031,P0.05)結(jié)論外周T淋巴細(xì)胞亞群比例改變,可能是HCV感染慢性化的重要原因之一。隨著HCV RNA表達(dá)水平的升高,可能是導(dǎo)致T淋巴細(xì)胞應(yīng)答能力下降的重要原因。ALT、AST只是反應(yīng)肝臟病理變化的炎癥指標(biāo)。
[Abstract]:Objective to investigate the relationship between T lymphocyte subsets in human peripheral venous blood and the degree of replication of hepatitis C virus (HCV) ribonucleic acid (RNAs) in patients with chronic hepatitis C (chronic hepatitis C) by alanine aminotransferase (alt) and alanine aminotransferase (alt). Methods 169 outpatients and inpatients with CHC from May 2012 to February 2013 in Department of Infectious Diseases, first affiliated Hospital of Anhui Medical University were collected. At the same time, 1 ml of EDTA-K2 anticoagulant peripheral venous blood and 4 ml of non-anticoagulant peripheral venous blood were obtained from 120 healthy subjects. The T cell subsets in peripheral anticoagulant venous blood were detected by flow cytometry. The replication concentration of hepatitis C virus ribonucleic acid (HCV) RNA in sera from adult patients and healthy controls was detected by fluorescence quantitative PCR. The percentage of CD4 T cells and CD4 / CD8 ratio in 1CHC patients were significantly lower than those in normal controls (49.55 鹵6.68) and 1.82 鹵0.11 (P 0.01), while the percentage of CD8 T cells (32.78 鹵5.48) was higher than that of normal controls (27.35 鹵4.32). The results of fluorescence quantitative PCR assay for the detection of CHC were as follows: the carrying capacity was more than 1.00 脳 10 ~ 5 copias / ml ~ (-1) in 57 cases. The loading capacity was 1.00 脳 10 ~ 3 / L 1.00 脳 10 ~ 5 copias / ml ~ (-1) and less than 1.00 脳 10 ~ (3) / ml ~ (-1) / ml ~ (-1) in 120 normal controls. The loading capacity was 1.0 脳 10 ~ (3) / 10 ~ (-1). With the increase of HCV RNA replication load, the percentage of CD8 T cells increased, while the percentage of CD4 T cells and the ratio of CD4 / CD8 decreased gradually. There were 77 cases of ALT abnormality in the 112 samples with CD4 / CD8 ratio > 1.00 脳 10 ~ 3 copies/ml. The abnormal rate of AST was 68.7%, and there were 70 cases of abnormal AST, the abnormal rate was 62.5%. Statistical analysis showed that the abnormality of alt increased with the increase of HCV-RNA content, and there was a positive correlation between the changes of alt AST concentration and the content of HCV-RNA. Conclusion the ratio of peripheral T lymphocyte subsets was changed, and there was no correlation between the changes of alt AST concentration and HCV-RNA content. It may be one of the important causes of chronic HCV infection. With the increase of HCV RNA expression level, it may be an important reason that T lymphocyte response ability decreases. Alt AST is only an inflammatory index reflecting the pathological changes of liver.
【學(xué)位授予單位】：安徽醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2014
【分類(lèi)號(hào)】：R512.63

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本文編號(hào)：1839448