本文選題：有償獻(xiàn)血員 + 抗-HCV陽性率　； 參考：《河北醫(yī)科大學(xué)》2009年碩士論文

【摘要】： 目的:了解河北趙縣“獻(xiàn)血村”村民HCV的感染情況及HCV基因型分布情況,通過統(tǒng)計(jì)分析推斷該村村民出現(xiàn)抗-HCV陽性的危險(xiǎn)因素,為減少HCV傳播和對(duì)HCV感染者進(jìn)行治理管理提供基礎(chǔ)資料,并探討HCV基因分型的方法。 方法:以河北省趙縣某“獻(xiàn)血村”全村520位村民為研究對(duì)象,進(jìn)行了一次橫斷面調(diào)查。對(duì)該村所有村民進(jìn)行了問卷調(diào)查,并對(duì)所有村民采集血液樣本,無菌分離血清。以酶聯(lián)免疫法(ELISA)法對(duì)所有520份血清進(jìn)行抗-HCV抗體檢測(cè);以RT-PCR法對(duì)其中可利用的483份血清分別擴(kuò)增HCV之5'UTR、C/E1、NS5B基因片段,雙脫氧鏈終止法測(cè)序;用Mega4.0軟件進(jìn)行HCV系統(tǒng)進(jìn)化分析,構(gòu)建系統(tǒng)進(jìn)化樹,判定基因亞型。 結(jié)果:所有研究對(duì)象總的抗-HCV血清陽性率為28.46%(148/520)。無獻(xiàn)血史村民的抗-HCV抗體陽性率為16.55%,有獻(xiàn)血史的研究對(duì)象中抗-HCV血清陽性率為42.80%(101/236),有獻(xiàn)血史與無獻(xiàn)血史村民之間的抗-HCV陽性率存在顯著性差異(P0.0001)。只獻(xiàn)全血的獻(xiàn)血員中抗-HCV抗體的陽性率為15.38%,只獻(xiàn)血漿的獻(xiàn)血員中抗-HCV抗體的陽性率則高達(dá)80.00%,既有獻(xiàn)全血又有獻(xiàn)漿史的獻(xiàn)血員中抗-HCV抗體的陽性率也高達(dá)69.30%。出賣血漿是有償獻(xiàn)血員出現(xiàn)抗-HCV血清陽性的一個(gè)相關(guān)因素(P=0.0037),但是賣全血卻不是其相關(guān)因素(P=0.7736),有手術(shù)史也是村民出現(xiàn)抗-HCV陽性的一個(gè)相關(guān)因素(P=0.0270)。獻(xiàn)全血年數(shù)/次數(shù)與抗-HCV陽性率之間及獻(xiàn)漿次數(shù)與抗-HCV陽性率之間存在劑量—反應(yīng)關(guān)系。但經(jīng)多因素logistic分析發(fā)現(xiàn)只有混合獻(xiàn)血、獻(xiàn)漿史與村民出現(xiàn)抗-HCV陽性之間存在相關(guān)性。HCV-RNA核酸定性檢測(cè)結(jié)果為陽性的人數(shù)是79人,其中的71份樣本成功地進(jìn)行基因分型,1b亞型的樣本數(shù)為37例,占52.11%;2a亞型的樣本數(shù)為34例,占47.89%。 結(jié)論:上個(gè)世紀(jì)八十年代末至九十年代初期間非法的單采漿過程中的不衛(wèi)生的操作存在交叉污染,是導(dǎo)致有償獻(xiàn)血員出現(xiàn)抗-HCV抗體危險(xiǎn)因素;高HCV感染率人群可能更易通過其他的經(jīng)皮傳播途徑向普通人群傳播丙型肝炎;該村居民感染的HCV基因型只有1b、2a兩種亞型;利用HCV之C/E1區(qū)域進(jìn)行系統(tǒng)進(jìn)化分析可作為HCV基因分型的研究方法。由于單采漿時(shí)的交叉污染是這兩種亞型的HCV都有同等的機(jī)會(huì)進(jìn)行傳播,因此這兩種基因亞型所占的比例趨于平衡。
[Abstract]:Objective: to investigate the infection of HCV and the distribution of HCV genotypes in the villagers of "blood donation village" in Zhaoxian County, Hebei Province, and to infer the risk factors of anti-HCV positive in the villagers by statistical analysis. To reduce the transmission of HCV and the management of HCV infection to provide basic information, and to explore the method of HCV genotyping. Methods: a cross-sectional investigation was carried out among 520 villagers in a "blood donation village" in Zhaoxian County, Hebei Province. A questionnaire survey was conducted among all the villagers in the village, and blood samples were collected and aseptic serum was isolated from all the villagers. All 520 sera were tested for anti-HCV antibody by Elisa, and 5 of HCV C / E1 NS5B gene fragments were amplified by RT-PCR method and sequenced by dideoxy chain termination method. HCV phylogenetic analysis was performed with Mega4.0 software. A phylogenetic tree was constructed to identify gene subtypes. Results: the total positive rate of anti-HCV in all subjects was 28. 46%-520%. The positive rate of anti-HCV antibody in villagers without blood donation history was 16.555.The positive rate of anti-HCV serum in the study subjects with history of blood donation was 42.801 / 2360.The positive rate of anti-HCV was significantly different between the villagers with and without blood donation history (P 0.0001). The positive rate of anti-HCV antibody was 15.38 in the whole blood donors and 80.000 in the blood donors who only donated plasma. The positive rate of anti-HCV antibody was 69.30 in the blood donors who had both the whole blood donation and the plasma donation history. Selling plasma is a relative factor of anti-HCV seropositive in paid blood donors (P0. 0037), but selling whole blood is not related factor P0. 7736. A history of operation is also a related factor of anti-HCV positive in villagers (P0. 0270). There was a dose-response relationship between the number / times of whole blood donation and the positive rate of anti-HCV and the number of times of plasma donation and the positive rate of anti-HCV. However, according to multivariate logistic analysis, only mixed blood donation was found. The number of people who showed positive results by qualitative detection of HCV-RNA nucleic acid was 79, and the correlation between the history of plasma donation and the presence of anti-HCV positive in villagers was 79. Of these 71 samples were successfully genotyped in 37 cases, accounting for 52.11a subtype in 34 cases (47.89%). Conclusion: the unhygienic operation of illegal mono pulping during the late 1980s to the early 1990s is a risk factor for the emergence of anti-HCV antibodies in paid blood donors. The population with high HCV infection rate may be more likely to transmit hepatitis C to the general population through other transcutaneous transmission routes, and only 1bm2a subtype of HCV genotype was infected in this village population. Phylogenetic analysis based on the C/E1 region of HCV can be used as a genotyping method for HCV. Because the cross-contamination of the two subtypes has the same chance of transmission, the proportion of the two subtypes tends to be balanced.
【學(xué)位授予單位】：河北醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2009
【分類號(hào)】：R193;R181.3

【引證文獻(xiàn)】

相關(guān)期刊論文 前2條

1 馬書章;劉平;梁俊杰;劉樂霞;趙世紅;;滄州市無償獻(xiàn)血員丙型肝炎抗體檢測(cè)結(jié)果分析[J];醫(yī)學(xué)動(dòng)物防制;2010年08期

2 馬書章;紀(jì)英姿;趙世紅;劉建嶺;梁俊杰;;輸血傳播肝炎的預(yù)防與控制研究[J];醫(yī)學(xué)動(dòng)物防制;2011年01期

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