【摘要】：研究背景乙型肝炎病毒(Hepatitis B virus,HBV)感染嚴(yán)重危害人類健康,隨著人們對乙肝病毒認(rèn)識的不斷深入,乙肝病毒基因型的研究越來越受到人們重視,中國乙型肝炎病毒基因型在地理位置和人口學(xué)分布上也有明顯差異,這可能與不同區(qū)域的人群,種族,乙肝病毒感染率及生活方式等相關(guān),本文旨在探究乙型肝炎病毒基因型在中國不同地區(qū)和民族的分布特點(diǎn),以及不同乙肝病毒基因型與不同肝病臨床表現(xiàn)之間的聯(lián)系,這項研究的發(fā)現(xiàn)有助于評估未來乙肝病毒感染的疾病負(fù)擔(dān),并且有助于發(fā)展乙肝病毒感染的控制措施。方法在萬方數(shù)據(jù)庫和NCBI數(shù)據(jù)庫檢索從2000年到2014年間有關(guān)中國HBV基因型分布的文章,根據(jù)嚴(yán)格的納入和排除標(biāo)準(zhǔn)進(jìn)行文獻(xiàn)納入,然后再按照地區(qū)、民族及感染類型的不同將不同基因型歸類,最終應(yīng)用Meta分析來研究中國基因型分布特點(diǎn)及其臨床意義。結(jié)果在數(shù)據(jù)庫檢索出560篇有關(guān)乙肝病毒基因型的原始文獻(xiàn),經(jīng)納入排除標(biāo)準(zhǔn)后有220篇文獻(xiàn)符合條件進(jìn)行數(shù)據(jù)收集及數(shù)據(jù)統(tǒng)計,我們得知中國的HBV基因型主要以B基因型和C基因型為主,區(qū)域1(北部地區(qū))HBV基因型A、B、C、B/C、D和其他型分別為0.1%、22.2%、69.1%、3.8%、0.5%和1.5%,其中C基因型比例顯著高于其它區(qū)域(P0.05);區(qū)域2(中部地區(qū))HBV基因型A、B、C、B/C、D和其他型分別為0.2%、62.6%、27.4%、3.8%、0.5%和2.4%,其中B基因型比例顯著高于其它區(qū)域(P0.05);區(qū)域3(南部地區(qū))HBV基因型A、B、C、B/C、D和其他型分別為0.6%、36.3%、49.4%、2.8%、2.6%和3.4%,其中C基因型比例顯著高于區(qū)域2的27.4%(P0.05);區(qū)域4(青藏高原)感染HBV HBV基因型A、B、C、B/C、D和其他型分別為6.0%、22.5%、11.7%和59.3%,其中C/D混合型比例顯著高于其他區(qū)域(P0.05)。不同民族的基因型分布也顯著不同,藏族人群的C/D混合型比例(49.3%)顯著高于其他民族(所有P0.05),哈薩克族的D基因型比例(58.1%)顯著高于其他民族(所有P0.05)。此外,以慢性HBs Ag攜帶顯的統(tǒng)計學(xué)差異。并且HBs Ag的水平隨著疾者作為對照組,C基因型與慢性乙型肝炎、HBV相關(guān)性肝硬化、肝癌顯著相關(guān)(ORs:1.979、3.888、4.399,所有P0.001)。結(jié)論中國主要基因型為B基因型和C基因型,不同地區(qū)和民族的HBV基因型分布也顯著不同,中國南部地區(qū)和北部地區(qū)以C基因為主,中部地區(qū)以B基因型為主,并且本研究表明B基因型可能是中國乙型肝炎病毒的起源基因,同時本研究表明藏族人群中的乙肝病毒基因型以C/D混合型為主,回族和維吾爾族人群中的乙肝病毒基因型主要為C基因型和D基因型,D基因型主要分布于哈薩克族,另外,研究表明C基因型更有可能引起嚴(yán)重的肝損害,如肝硬化、肝細(xì)胞癌等。
[Abstract]:Background Hepatitis B virus (Hepatitis B virus,HBV) infection is a serious hazard to human health. With the deepening of people's understanding of hepatitis B virus, the study of hepatitis B virus genotypes has been paid more and more attention. There are also significant differences in geographic location and demographic distribution of hepatitis B virus genotypes in China, which may be related to population, race, HBV infection rate and lifestyle in different regions. The purpose of this study was to investigate the distribution of hepatitis B virus genotypes in different regions and nationalities in China, and the relationship between different hepatitis B virus genotypes and clinical manifestations of different liver diseases. The findings of the study help assess the future burden of hepatitis B infection and help develop control measures for hepatitis B infection. Methods articles on the distribution of HBV genotypes in China from 2000 to 2014 were searched in Wanfang database and NCBI database. The articles were included according to strict inclusion and exclusion criteria, and then by region. Different genotypes were classified in different ethnic groups and infection types. Finally, Meta analysis was used to study the distribution characteristics of Chinese genotypes and their clinical significance. Results 560 original literatures on HBV genotypes were retrieved from the database, 220 of which were eligible for data collection and statistics after inclusion of exclusion criteria. We know that the HBV genotypes in China are mainly genotype B and genotype C. In region 1 (northern region), the HBV genotypes AHB / C / C / C / D and others were 0.1% and 1.5%, respectively. The proportion of genotype C was significantly higher than that of other regions (P0.05); in region 2 (central region), the HBV genotypes of HBV were 0.22.627.4% and 2.4%, respectively, and the proportion of genotype B was significantly higher than that of other regions (P 0.05). The proportion of genotype B was significantly higher than that of other regions (P0.05), and the ratio of genotype B to genotype B was significantly higher than that of other regions (P0.05). The ratio of genotype B to genotype B was significantly higher than that of other regions (P0.05). The ratio of genotype B to genotype B was 0.5% and 2.4%, respectively. The ratio of genotype C was significantly higher than that of other regions (P0.05); the proportion of genotype C of region 3 (southern region) was significantly higher than that of region 2 (P 0.05); the proportion of genotype C of region 3 (Qinghai-Xizang plateau) infected with HBV HBV genotype ABBU / C / C was 0.6% and 3.44%, respectively. The percentage of genotype C was significantly higher than that of region 2 (P0.05); the proportion of region 4 (Qinghai-Tibet Plateau) infected with HBV HBV genotype ABBCU / C / C and other types was higher than that of region 2 (P0.05); the percentage of genotype C was significantly higher than that of region 2 (P0.05); The ratio of C / D mixed type was significantly higher than that of other regions (P0.05). The proportion of C / D mixed genotype of Tibetan population (49.3%) was significantly higher than that of other ethnic groups (all P0.05), and that of Kazak nationality (58.1%) was significantly higher than that of other ethnic groups (all P0.05). In addition, there was significant statistical difference in chronic HBs Ag carriers. The level of HBs Ag was significantly correlated with chronic hepatitis B associated cirrhosis and liver cancer (ORs:1.979,3.888,4.399, all P 0.001). Conclusion the main genotypes in China are genotype B and genotype C, and the distribution of HBV genotypes in different regions and nationalities is also significantly different. C gene is dominant in the southern and northern regions of China, and genotype B in the central part of China. This study suggests that genotype B may be the origin gene of hepatitis B virus in China, and the genotype of hepatitis B virus in Tibetan population is mainly composed of C / D mixed genotype. In the Hui and Uygur population, hepatitis B virus genotype C and D genotype are mainly distributed in Kazak nationality. In addition, studies show that genotype C is more likely to cause severe liver damage, such as liver cirrhosis. Hepatocellular carcinoma, etc.
【學(xué)位授予單位】：安徽醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R512.62

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