本文選題：肝炎相關(guān)病毒 + 新生兒黃疸��； 參考：《青島大學(xué)》2016年碩士論文

【摘要】：目的:1、了解目前在淄博地區(qū)的新生兒人群中黃疸發(fā)生的的現(xiàn)狀。2、分析引起新生兒黃疸病毒感染的主要病原體,確定最適合新生兒黃疸病毒感染的聯(lián)合檢測首選套餐。3、確定引起新生兒黃疸主要的病毒及其在母乳存在的相關(guān)性分析。4、新生兒感染肝炎相關(guān)病毒后對其本身肝臟造成損傷的情況分析。材料和方法:收集淄博地區(qū)(淄博市第三人民醫(yī)院和淄博市張店區(qū)人民醫(yī)院)2013年2月至2014年10月入院的新生兒血液和及其母親乳汁各1427份,用熒光定量PCR方法及酶聯(lián)免疫吸附試驗(yàn)(ELISA)的方法檢測新生兒外周血中人巨細(xì)胞病毒(HCMV)、單純皰疹病毒(HSV)、甲肝病毒(HAV)、乙肝病毒(HBV)、丙肝病毒(HCV)、EB病毒(EBV)等病毒的情況,并進(jìn)行統(tǒng)計(jì)學(xué)處理;將引起新生兒人群中出現(xiàn)黃疸的主要感染病毒對其母親乳汁進(jìn)行回顧性相關(guān)病毒檢測,并進(jìn)行統(tǒng)計(jì)學(xué)比較;對引起新生兒黃疸的主要病毒的陽性血清樣本在全自動生化分析儀上進(jìn)行肝功能主要指標(biāo)進(jìn)行檢測分析,統(tǒng)計(jì)肝功能檢測指標(biāo)結(jié)果,并與所選的對照組進(jìn)行統(tǒng)計(jì)比較。結(jié)果:1、1427例標(biāo)本中病毒感染陽性數(shù)274例,其中HCMV 157例(11.00%)、HAV-Ig M 2例(0.14%)、HBV 92例(6.45%)、HCV-Ig M 3例(0.21%)、HSV-II-Ig M 12例(0.84%)、EBV 8例(0.56%)。HCMV和HBV占據(jù)比例較高,在病毒感染中分別占11.00%和6.45%。2、黃疸組中HCMV陽性為145例,非黃疸組HCMV陽性為12例,兩組HCMV差異顯著,差異有統(tǒng)計(jì)學(xué)意義(p0.01)。3、1427例新生兒血液標(biāo)本中,HCMV陽性157(11.0%)例,陰性1270(89.0%)例;1427例母親乳汁樣本,HCMV陽性849(59.50%)例,陰性578(40.50%)例;對比差異顯著,有統(tǒng)計(jì)學(xué)意義(p0.01)。4、黃疸組中HCMV陽性者肝臟功能TBIL、GGT、AST、ALT等各項(xiàng)指標(biāo)都高于HCMV陰性者,兩者比較有統(tǒng)計(jì)學(xué)意義(p0.01)。結(jié)論:淄博地區(qū)黃疸新生兒病毒的感染主要是HCMV與HBV,其中HCMV157例(57.30%),占據(jù)一半以上,說明在本地區(qū)HCMV感染幾率較高,應(yīng)引起高度關(guān)注。在新生兒黃疸患兒病毒檢測時(shí)可優(yōu)先考慮這兩項(xiàng)檢測,以達(dá)到最經(jīng)濟(jì)而又最快的找到原因,及時(shí)治療。新生兒血液標(biāo)本HCMV陽性率(11.0%)低于新生兒母親乳汁樣本(59.5%),因此盡早對母親進(jìn)行相關(guān)HCMV的檢測也很有意義,這樣可降低因喂養(yǎng)母乳而引起新生兒感染病毒。黃疸組HCMV陽性者肝臟功能TBIL、GGT、AST、ALT檢測指標(biāo)等都高于HCMV陰性者,兩者比較差異顯著,說明新生兒在巨細(xì)胞病毒感染后肝臟的損傷程度比未感染巨細(xì)胞病毒的肝臟損傷程度大。
[Abstract]:Objective: 1, to understand the status quo of jaundice in the newborns in Zibo area, and to analyze the main pathogens of neonatal jaundice virus infection. To determine the most suitable combination of neonatal jaundice virus infection. 3, determine the main causes of neonatal jaundice virus and its correlation in breast milk analysis. 4. Newborns infected with hepatitis associated virus on their own liver Analysis of the damage caused. Materials and methods: 1427 neonatal blood samples and their mothers' milk were collected from February 2013 to October 2014 in Zibo region (Zibo third people's Hospital and Zibo Zhangdian District people's Hospital). Human cytomegalovirus (HCMV), herpes simplex virus (HSV), hepatitis A virus (HAV), hepatitis B virus (HBV), hepatitis C virus (HCV) and Epstein-Barr virus (EBV) in the peripheral blood of neonates were detected by fluorescence quantitative PCR and enzyme linked immunosorbent assay (Elisa). The main infection virus causing jaundice in the newborns was detected by retrospective analysis of the mother's milk related virus, and statistical comparison was carried out. The positive serum samples of the main virus causing neonatal jaundice were detected and analyzed on the automatic biochemical analyzer to analyze the main indexes of liver function, and the results of liver function were counted and compared with those of the control group. Results there were 274 cases of viral infection in 1 427 specimens, of which HCMV 157 cases (11.00%) and HAV-Ig M (2 cases) 0.145.92 cases with HCV-Ig M 3 cases with HCV-Ig M 0.21% with HSV-II-Ig M 12 cases with 0.84EBV 8 cases with 0.56.HCMV and HBV accounted for 11.00% and 6.45.2in jaundice group, the positive rate of HCMV was 14.5 cases, and the positive rate of HCMV was 11.00% and 6.45.2in the jaundice group, the positive rate of HCMV was 0.56% and 6.45% respectively, and the positive rate of HCMV was 6.45% in the jaundice group, and the positive rate was 6.45% in the jaundice group. In non-jaundice group, 12 cases were HCMV positive, and the difference between the two groups was significant. The difference was statistically significant in 1570.11.0% of the blood samples of newborns, 1427 cases were negative (12700.89.0), 1427 cases were positive in milk samples of mothers (84959.50), and 578% (40.50%), the difference was significant. In jaundice group, the liver function of HCMV positive group was higher than that of HCMV negative group. Conclusion: the infection of jaundice neonatal virus in Zibo area is mainly HCMV and HBV, among which 57.30 cases of HCMV157 account for more than half, indicating that the probability of HCMV infection is high in this area, which should be paid close attention to. In order to find the most economical and quickest cause, we can give priority to these two tests in the detection of neonatal jaundice virus and treat them in time. The positive rate of HCMV in blood samples of newborns was lower than that of breast milk samples of newborns, so it was also significant to detect the related HCMV of mothers as soon as possible, which could reduce the infection of newborns caused by breast-feeding. In jaundice group, the liver function of HCMV positive group was higher than that of HCMV negative group, indicating that the degree of liver damage in newborns after CMV infection was greater than that in uninfected cytomegalovirus group.
【學(xué)位授予單位】：青島大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2016
【分類號】：R722.17
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本文編號：1974653