本文選題：乙型肝炎病毒 + 血清流行病學(xué)��； 參考：《中國疾病預(yù)防控制中心》2010年碩士論文

【摘要】： 目的：了解遂寧地區(qū)人群乙型肝炎病毒(HBV)的感染現(xiàn)狀及病毒基因型及血清亞型流行特征；評價(jià)乙肝疫苗納入兒童免疫策略后的效果,為進(jìn)一步制定乙肝的防制策略提供科學(xué)依據(jù)。 方法： (1)抽樣方法：在遂寧六個(gè)縣級行政區(qū)域內(nèi),采用多階段整群隨機(jī)抽樣方法,在1-59歲常住人口選取1～4歲、5～14歲、15～59歲三個(gè)年齡組,抽取符合調(diào)查要求的調(diào)查對象,共采集血清樣本1468人份。 (2)檢測方法：用酶聯(lián)免疫法(ELISA)檢測乙肝病毒表面抗原(HBsAg)、乙肝病毒表面抗體(抗-HBs)和乙肝病毒核心抗體(抗-HBc)；對乙肝病毒表面抗原(HBsAg)檢測陽性的血清樣本進(jìn)行HBV DNA提取,用巢氏PCR法擴(kuò)增提取HBV DNAS區(qū),根據(jù)PCR產(chǎn)物基因測序結(jié)果對樣本HBV進(jìn)行基因分型。 (3)統(tǒng)計(jì)方法：所有資料錄入EpiData3.1數(shù)據(jù)庫后,用SPSS13.0軟件進(jìn)行統(tǒng)計(jì)處理和分析。 結(jié)果：(1)HBV感染標(biāo)志血清流行病學(xué)特征(經(jīng)標(biāo)化后)：人群中HBsAg陽性率為16.83%,抗-HBs陽性率為43.71%,HBV感染率為77.83%。各年齡組之間HBsAg陽性率、HBV感染率差異有顯著的統(tǒng)計(jì)學(xué)意義(x2分別為48.01、259.55,P0.001)；人群中HBsAg陽性率男性和女性有顯著性差異(x2=11.14,p0.05)；不同地區(qū)人群HBsAg陽性率、HBV感染率均有顯著性差異(x2分別為33.56、60.17,p均0.01)；不同職業(yè)人群HBsAg陽性率、HBV感染率均有顯著性差異(x2分別為36.32、235.73,p均0.001)；不同文化程度人群HBsAg陽性率、HBV感染率均有顯著性差異(x2分別為37.95、123.31,p均0.001)；1992年后出生人群組HBsAg陽性率明顯低于1992年前出生人群組(x2=33.92,p0.01) (2)HBsAg陽性標(biāo)本病毒基因型分型結(jié)果：118例HBsAg陽性標(biāo)本中,B基因型40例(33.89%),C基因型73例(61.86%),D基因型5例(4.23%),未發(fā)現(xiàn)BCD以外的其他基因型。 (3) HBsAg陽性標(biāo)本病毒血清亞型分型結(jié)果：在118份樣品中42份(35.59%)為adr型,76份(64.41%)為adw型。 結(jié)論：1、遂寧地區(qū)仍是乙肝高流行地區(qū),乙肝疫苗大規(guī)模在低年齡段人群實(shí)施接種已達(dá)到一定效果并使該地區(qū)乙肝流行病學(xué)特征發(fā)生改變,但目前低年齡組人群HBsAg攜帶率仍高于全國平均水平。 2、遂寧地區(qū)乙肝病毒基因型別以B、C為主要基因型,其中C型基因占優(yōu)勢,存在少量D基因型。血清亞型的分布以adr\adw亞型為主,其中adw亞型占優(yōu)勢。
[Abstract]:Objective: to investigate the present situation of hepatitis B virus (HBV) infection and the epidemic characteristics of HBV genotype and serum subtype in the population of Suining, and to evaluate the effect of hepatitis B vaccine in children's immunization strategy. To provide scientific basis for the further formulation of hepatitis B prevention and control strategy. Methods: (1) sampling method: in six county administrative districts in Suining, a multi-stage cluster random sampling method was used to select three age groups of 1 to 59 years old resident population aged 1 to 59 years, and to select the survey subjects who met the requirements of the survey. A total of 1468 serum samples were collected. Methods: Elisa was used to detect hepatitis B virus surface antigen (HBsAg), anti-HBsAg and anti-HBc antibody (anti-HBcG). HBV DNA was extracted from serum samples which were positive for HBV surface antigen (HBs). The extracted HBV DNAS region was amplified by nested PCR and genotyping of sample HBV was carried out according to the result of PCR product gene sequencing. Statistical method: after all data are entered into EpiData3.1 database, statistical processing and analysis are carried out with SPSS13.0 software. Results the seroepidemiologic characteristics of the HBV infection marker were as follows: the positive rate of HBsAg and anti-HBs were 16.83and 43.71respectively, and the infection rate of HBV-positive was 77.830.The positive rate of anti-HBs was 43.71and the positive rate of anti-HBs was 77.83. There were significant differences in HBsAg positive rate and HBsAg infection rate among different age groups (48.01259.55p 0.001, P 0.001), there was significant difference in HBsAg positive rate between male and female, and there was significant difference in HBsAg positive rate and HBsAg infection rate among different population in different area. The positive rates of HBsAg in different occupational groups were significantly different. The positive rates of HBsAg were 36.32235.73 (P = 0.001), and the positive rates of HBsAg were significantly different among people with different educational levels (P < 0.01). The positive rates of HBsAg were 37.95123.31 (P = 0.001), respectively, and those of those born after 1992 were significantly higher than those of controls. The positive rate of HBsAg in the cohort was significantly lower than that in the pre-1992 group (P 0.01). The results of virus genotyping in HBsAg positive specimens of 10% HBsAg positive samples were as follows: among the 118 HBsAg positive specimens, 40 cases were of B genotype or 33.89%, and 73 cases of BCD C genotype (73 cases). There were 5 cases (4.23%) of D genotype and 5 cases (4. 23%). No genotype other than BCD was found. (3) the results of serotyping of HBsAg positive specimens: 42 of 118 samples were of adr type (64.41) and 42 of them were of adw type. ConclusionThe area of Suining is still a high epidemic area of hepatitis B, the large scale inoculation of hepatitis B vaccine in the low age group has achieved certain effect and changed the epidemiological characteristics of hepatitis B in this area. However, the HBsAg carrying rate in the low age group is still higher than the national average. 2. The main genotype of hepatitis B virus gene in Suining area was BHV C, in which type C gene was dominant, and a small number of genotype D existed. The distribution of serum subtypes was mainly adr\ adw, in which adw subtype was dominant.
【學(xué)位授予單位】：中國疾病預(yù)防控制中心
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2010
【分類號】：R512.62;R181.3

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