【摘要】： 目的為了了解內(nèi)蒙古不同地區(qū)、不同人群中乙肝的流行狀況,特別是實(shí)施大規(guī)模乙肝疫苗接種后的效果,開展此次全區(qū)范圍的乙肝血清學(xué)調(diào)查。通過(guò)本實(shí)驗(yàn)可以初步了解內(nèi)蒙古地區(qū)的乙肝病毒(HBV)基因型分布特點(diǎn),為推測(cè)乙肝的流行趨勢(shì)提供數(shù)據(jù)資料。方法在內(nèi)蒙古地區(qū)12個(gè)盟市,采用多階段抽樣方法,在1-61歲常住人口選取1～6歲、7～16歲、17-61歲三個(gè)年齡組,共采集血清樣本4021份。統(tǒng)一用ELISA方法檢測(cè)乙肝表面抗原(HBsAg)、乙肝病毒表面抗體(HBsAb)、乙肝病毒核心抗體(HBcAb),對(duì)HBsAg陽(yáng)性者再進(jìn)行乙肝病毒e抗原(HBeAg)和乙肝病毒e抗體(HBeAb)檢測(cè)。并對(duì)46份乙肝大三陽(yáng)血樣進(jìn)行HBV DNA提取,用PCR實(shí)驗(yàn)擴(kuò)增提取到的HBV DNA S區(qū),根據(jù)PCR產(chǎn)物基因測(cè)序結(jié)果對(duì)樣本HBV進(jìn)行基因分型。結(jié)果內(nèi)蒙古地區(qū)HBsAg人群總體陽(yáng)性率2.71%,比1992年調(diào)查結(jié)果(6.35%)有明顯降低。HBV人群總體感染率53.64%,比1992年調(diào)查結(jié)果(37.16%)有明顯增高。本實(shí)驗(yàn)共46份樣本血清的PCR體系測(cè)序成功。其中B型1例(2.17%),C型43例(93.48%),D型2例(4.35%)未發(fā)現(xiàn)其它HBV的基因型。結(jié)論內(nèi)蒙古地區(qū)不同地區(qū)人群之間的HBsAg陽(yáng)性率和HBV感染率差異有統(tǒng)計(jì)學(xué)意義(P＜0.01)。我區(qū)農(nóng)村是我區(qū)乙肝高流行地區(qū)。針灸、創(chuàng)傷美容這兩個(gè)因素為乙肝感染的危險(xiǎn)因素。1992年前后出生的兩個(gè)人群的HBsAg感染率之間差異有統(tǒng)計(jì)學(xué)意義(P＜0.01),1992年前后出生的兩個(gè)人群的HBsAb感染率之間差異有統(tǒng)計(jì)學(xué)意義(P＜0.01),這可以說(shuō)明1992年內(nèi)蒙古地區(qū)乙肝疫苗納入兒童計(jì)劃免疫管理實(shí)施效果明顯。2002年前后出生的兩個(gè)人群的HBsAg感染率之間差異有統(tǒng)計(jì)學(xué)意義(P＜0.01),2002年前后出生的兩個(gè)人群的HBsAb感染率之間差異有統(tǒng)計(jì)學(xué)意義(P＜0.01),這可以說(shuō)明2002年將乙肝疫苗納入兒童計(jì)劃免疫及GAVI項(xiàng)目實(shí)施效果明顯。內(nèi)蒙古地區(qū)漢族人群中HBV的感染以C基因型HBV為主,B、D基因型HBV各占很少比例,未發(fā)現(xiàn)其他基因型HBV。既本實(shí)驗(yàn)共46份樣本血清的PCR體系測(cè)序成功:B型1例(2.17%),C型43例(93.48%),D型2例(4.35%)。未發(fā)現(xiàn)其他基因型。
[Abstract]:Objective to investigate the prevalence of hepatitis B in different areas and populations in Inner Mongolia, especially the effect of mass hepatitis B vaccination, and to carry out a serological survey of hepatitis B in the whole region. The distribution of hepatitis B virus (HBV) genotypes in Inner Mongolia can be preliminarily understood by this experiment, and the data can be provided for the prediction of hepatitis B epidemic trend. Methods A total of 4021 serum samples were collected from 12 cities in Inner Mongolia. 4021 serum samples were collected from the resident population aged 1-61 years in three age groups, I. e., 1 or 6 years old, 7 ~ 16 years old and 17 to 61 years old. Hepatitis B surface antigen (HBsAg),) hepatitis B virus surface antibody (HBsAb),) hepatitis B virus core antibody (HBcAb),) was detected by ELISA method in HBsAg positive patients and then hepatitis B virus e antigen (HBeAg) and hepatitis B virus e antibody (HBeAb) were detected in HBsAg positive patients. HBV DNA was extracted from 46 samples of hepatitis B positive blood samples, and the extracted HBV DNA S region was amplified by PCR experiment. According to the results of PCR product gene sequencing, the sample HBV was genotyped. Results the overall positive rate of HBsAg in Inner Mongolia was 2.71, which was significantly lower than that in 1992 (6.35%). The total infection rate of HBV was 53.64, which was significantly higher than that of 1992 (37.16%). The PCR system of 46 serum samples was sequenced successfully. One case of type B (2.17% of), C type 43 cases (93.48%) of), D type 2 cases (4.35%) did not find other HBV genotypes. Conclusion there were significant differences in HBsAg positive rate and HBV infection rate among different population in Inner Mongolia (P < 0. 01). My district countryside is my district hepatitis B high epidemic area. Acupuncture, trauma and beauty were the risk factors of hepatitis B infection. There was a significant difference in HBsAg infection rate between the two groups born before and after 1992 (P < 0. 01). There was a significant difference in HBsAb infection rate between the two populations born around 1992 (P < 0. 01). It can be concluded that the effect of applying hepatitis B vaccine into children's immunization management in Inner Mongolia in 1992 is obvious, and the difference of HBsAg infection rate between the two groups born around 2002 is statistically significant (P < 0. 01). The difference of HBsAb infection rate between the two populations before and after 2002 was statistically significant (P < 0. 01), which indicated that the hepatitis B vaccine was introduced into the children's immunization program and the implementation of GAVI project was effective in 2002. In Inner Mongolia Han population, genotype C HBV was the main type of HBV infection, while genotype B D HBV accounted for a small proportion. No other genotypes of HBV. were found. The PCR system of 46 serum samples was sequenced successfully: type B (2.17%), C 43 cases, 93.48%), D 2 cases (4.35%). No other genotypes were found.
【學(xué)位授予單位】：內(nèi)蒙古醫(yī)學(xué)院
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2009
【分類號(hào)】：R512.62;R181.3

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