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  本文關(guān)鍵詞： 乙型肝炎病毒 血清流行病學(xué) 免疫接種 基因型 巢式聚合酶鏈反應(yīng)　出處：《安徽醫(yī)科大學(xué)》2009年碩士論文　論文類型：學(xué)位論文

【摘要】： 目的了解現(xiàn)階段安徽省皖江地區(qū)自然人群乙型肝炎流行水平與流行強(qiáng)度及乙肝疫苗的接種情況;描述乙肝病毒(HBV)感染狀況及HBV基因型的分布狀況;探討HBV感染主要血清標(biāo)志物與基因型的關(guān)系。為了解安徽省乙肝流行規(guī)律提供基礎(chǔ),為乙肝防治工作提供依據(jù)。 方法(1)以安徽省巢湖市、池州市為研究現(xiàn)場。自行設(shè)計調(diào)查問卷,采用分層整群抽樣方法對2個城市小區(qū)、7個農(nóng)村行政村的自然人群開展以家庭為單位的問卷調(diào)查。問卷內(nèi)容包括:一般人口學(xué)資料,乙肝相關(guān)知識,醫(yī)源性接觸史,免疫史及生活接觸史。 (2)問卷調(diào)查完成后,每名調(diào)查對象抽取3ml肘靜脈血,共采集血標(biāo)本2282份。對所收集的血標(biāo)本用ELISA方法檢測HBV感染標(biāo)志,即乙肝五項HBsAg、HBsAb、HBeAg、HBeAb及HBcAb;對224份表面抗原(HBsAg)陽性的血清用濃縮液裂解法提取HBV DNA;用型特異性引物巢式PCR法檢測HBV DNA A-F基因型。 結(jié)果(1)在2282例血清標(biāo)本中,乙肝五項HBsAg、HBsAb、HBeAg、HBeAb及HBcAb流行率分別為9.8%、43.5%、1.0%、7.8%、10.3%;HBV總感染率(HBV流行率)為40.6%(926/2282);標(biāo)化HBsAg流行率為9.3%,標(biāo)化HBV流行率為35.4%。HBsAg流行率男性高于女性(χ~2= 3.992,P0.05),HBsAg流行率城鄉(xiāng)差異不顯著(χ~2=0.027,P0.05)。乙肝疫苗接種率為24.7%(539/2282),10歲以下年齡組疫苗接種率最高為97.4%(76/78),學(xué)生疫苗接種率較高為78.2%(355/454),農(nóng)村人群疫苗接種率(19.1%)低于城市人群(37.6%)(χ~2=84.682,P0.01)。接種乙肝疫苗后HBsAg及HBV流行率均顯著降低(P0.01)。 (2)在224份HBsAg陽性的血標(biāo)本中,共呈現(xiàn)5種模式:①HBsAg、HBeAg、HBcAb(1、3、5項)均陽性者18例(8.0%),②HBsAg、HBeAb、HBcAb(1、4、5項)陽性者160例(71.4%),③HBsAg、HBcAb(1、5項)陽性者36例(16.1%),④HBsAg、HBeAg(1、4項)陽性者4例(1.8%),⑤僅HBsAg陽性者6例(2.7%)。HBV基因型檢出率分別為B型54.9%、C型32.6%、BC混合型7.1%,另外有12例未分出型別(5.4%)。HBeAg陽性標(biāo)本基因型檢出率為100%;各基因型在HBeAg陽性組與陰性組中分布有差異(χ~2=8.323,P=0.04),C型在HBeAg陽性者中檢出率(59.1%)高于HBeAg陰性者(29.7%),HBeAg陰性者B型檢出率(56.9 %)高于HBeAg陽性者(36.4%)。 結(jié)論(1)安徽省皖江地區(qū)HBeAg流行率為9.8%,標(biāo)化流行率為9.3%,為全國乙肝高流行區(qū);乙肝疫苗接種率為24.7%,標(biāo)化率為35.7%,農(nóng)村乙肝疫苗接種率偏低。乙肝疫苗的接種能有效提高抗-HBs陽性率,減少HBV感染機(jī)會。 (2)皖江地區(qū)自然人群HBV基因型以B型、C型為主,B型為優(yōu)勢基因型;HBV基因型與血清感染標(biāo)志物有一定關(guān)系;型特異性多引物對巢式PCR方法適宜大樣本的基因型檢測。
[Abstract]:Objective to investigate the prevalence level and intensity of hepatitis B and the vaccination of hepatitis B vaccine among the natural population in Anhui Province at present, and to describe the status of hepatitis B virus hepatitis B virus (HBV) infection and the distribution of HBV genotypes. To explore the relationship between the main serum markers and genotypes of HBV infection, to provide the basis for understanding the epidemic rule of hepatitis B in Anhui Province, and to provide the basis for the prevention and treatment of hepatitis B. Methods 1) A questionnaire was designed in Chaohu City, Anhui Province, Chizhou City, Anhui Province. Using stratified cluster sampling method, the natural population in 2 urban districts and 7 rural administrative villages were investigated with a family questionnaire. The questionnaire included: general demographic data, hepatitis B related knowledge, iatrogenic contact history, and so on. History of immunity and life contact. 2) after the completion of the questionnaire, 2282 blood samples were collected from 3ml of cubitus vein blood collected from each of the subjects. The ELISA method was used to detect the HBV infection markers in the collected blood samples. Two hundred and twenty-four sera with positive HBsAg were extracted by concentrated solution lysis method, and HBV DNA A-F genotypes were detected by nested PCR with type specific primers. Results in 2282 serum samples, The prevalence rates of HBeAb and HBcAb in HBs were 9.8 and 9.8, respectively. The total infection rate of HBeAb and HBeAb in hepatitis B hepatitis B were 40.6 / 926 / 2282and 9.3b respectively (蠂 ~ 2 = 3.992P 0.05). There was no significant difference between urban and rural areas (蠂 ~ 2 = 0.027, P 0.05). The rate of hepatitis B vaccine vaccination was not significantly different between urban and rural areas (蠂 ~ 2 = 3.992P 0.05). The standard HBsAg prevalence rate was 9.3%, and the standard HBV prevalence rate was 35.4.HBsAg prevalence rate was higher in males than in females (蠂 ~ 2 = 3.992P 0.05) (蠂 ~ 2 = 0.027 P 0.05). The prevalence rate of hepatitis B vaccine was not significantly different between urban and rural areas (蠂 ~ 2 = 3.992P 0.05). The highest vaccination rate was 97.447% / 78% in the group under 10 years of age and the higher rate was 78.2% / 355454% in the students, and 19.1g in the rural population. It was lower than that in the urban population (蠂 2 84.682% P 0.01g). The prevalence rates of HBsAg and HBV were significantly lower than those of the urban population (蠂 284. 682% P 0. 01), and the prevalence rates of HBsAg and HBV were significantly lower than those of the urban population (蠂 2 84. 682% P 0. 01) after the hepatitis B vaccine was inoculated, the prevalence rates of both HBsAg and HBV were significantly lower than that of the urban population (P 0. 01). (2) of the 224 HBsAg positive blood samples, A total of 16. 1HBeHBeAg / HBcAb1) positive patients (18 cases with HBeAg + HBcAb1) were positive (18 cases with HBeAg + HBcAb1 / 45) (160 cases with 71.4 HBcAb15) were positive (36 cases were positive with 16. 1HBeAg / HBeAg) (4 cases with HBsAg positive only 6 cases with HBsAg positive 6 cases with HBsAg positive 6 cases with B type 54.94.9C type 32.66.6B mixed type 7.1b), and there were 6 cases with HBsAg positive only. The detection rate of HBV genotype was B type 54.94.9C type 32.66B mixed type 7.1b respectively, and there were 6 cases with HBsAg positive only. The detection rate of HBV genotype was 7.1g / c, 54.94.90%, respectively. The genotypic rate of 12 cases with positive HBeAg was 100, and there was significant difference in the distribution of genotype between HBeAg positive group and negative group (蠂 2 + 8.323). The detection rate of type C in HBeAg positive group was 59.1% higher than that in HBeAg negative group (56.9%). It was higher than that in HBeAg positive group (56.9%), and was higher than that in HBeAg positive group (56.9%), and the positive rate of HBeAg-negative group was 56.9% (P < 0.05), which was higher than that of HBeAg positive group (P < 0.05%), which was higher than that of HBeAg negative group (P < 0.05%). Conclusion (1) the prevalence rate of HBeAg is 9.8 and the standardized prevalence rate is 9.3 in Anhui Province, which is the high epidemic area of hepatitis B in China. The coverage rate of hepatitis B vaccine was 24.7% and the standardized rate was 35.7.The coverage rate of hepatitis B vaccine in rural areas was low. The positive rate of anti-HBs was increased effectively and the chance of HBV infection was reduced by the inoculation of hepatitis B vaccine. (2) the genotype of HBV in natural population in Anhui River area was mainly type B and B genotype. The genotype of HBV was related to the markers of serum infection, and the nested PCR method was suitable for the detection of genotypes in large samples.
【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】：2009
【分類號】：R512.62;R181.3

【引證文獻(xiàn)】

相關(guān)期刊論文 前1條

1 武新梅;謝奇鵬;葉松道;陳華;;溫州地區(qū)1268對行IVF/ICSI治療夫婦HBV感染狀況分析[J];中國衛(wèi)生檢驗雜志;2011年11期

相關(guān)碩士學(xué)位論文 前1條

1 汪娟;安徽省部分地區(qū)乙型肝炎分子流行病學(xué)初步研究[D];安徽醫(yī)科大學(xué);2011年

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本文編號：1529876