本文關(guān)鍵詞：新疆652例漢、維、哈族HCV感染者病毒基因型研究　出處：《新疆醫(yī)科大學(xué)》2015年碩士論文　論文類(lèi)型：學(xué)位論文

  更多相關(guān)文章： 新疆 丙型肝炎 基因分型

【摘要】：目的:分析新疆某三甲醫(yī)院的漢、維、哈族HCV感染者的病毒基因型,了解三個(gè)民族HCV感染主要基因型的差異。應(yīng)用逆轉(zhuǎn)錄PCR擴(kuò)增和反向點(diǎn)雜交技術(shù)進(jìn)行HCV基因分型的檢測(cè)方法,初步了解漢、維、哈族HCV感染者病毒基因型特點(diǎn),為新疆地區(qū)HCV的基礎(chǔ)研究、臨床治療和疾病預(yù)防提供依據(jù)。方法:收集2014年新疆某三甲醫(yī)院診斷為丙型肝炎的漢、維、哈族感染者血清標(biāo)本,先進(jìn)行熒光定量PCR檢測(cè)病毒載量,載量大于1×103 copies/ml的再用PCR-反向點(diǎn)雜交法進(jìn)行HCV基因分型檢測(cè)。結(jié)果:669份HCV感染血清樣本PCR-反向點(diǎn)雜交基因分型成功652例,檢出率為97.4%(652/669),檢出6種基因型,分別為1b、2a、3a、3b、6a以及混合型1b/2a,其中1b型395例(60.58%),2a型188例(28.83%)。1b、2a型分布在漢、維、哈族之間有差異,且差異有統(tǒng)計(jì)學(xué)意義(P0.05)。男性HCV感染者中2a型和女性HCV感染者中1b、2a型在漢、維、哈族構(gòu)成比中有差異,且差異有統(tǒng)計(jì)學(xué)意義(P0.05)。烏魯木齊地區(qū)HCV感染者中,2a型在漢、維、哈族病例分布有差異,且差異有統(tǒng)計(jì)學(xué)意義(P0.05)。其他地區(qū)HCV感染者中,1b、2a型在漢、維、哈族分布中有差異,且差異有統(tǒng)計(jì)學(xué)意義(P0.05),在哈族病例中,1b、2a型所占比例較高,尤其是2a型,所占比例高于漢族、維族病例。1b型HCV感染者在各臨床類(lèi)型分布中有差異,且差異有統(tǒng)計(jì)學(xué)意義(P0.05),丙肝相關(guān)肝癌中,1b型所占比例較高,達(dá)83.33%。1b型的平均RNA載量為(1.41×106±1.43×105)copies/ml,2a型的平均RNA載量為(7.84×105±1.43×105)copies/ml,兩者差異有統(tǒng)計(jì)學(xué)意義(P0.05)。載量水平(1.00×104~9.99×104)和(1.00×107~9.99×107),在1b、2a型和其他型之間有差異,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論:新疆652例HCV感染者病毒基因型以1b型為主,其次是2a型,1b、2a型在漢、維、哈族丙型肝炎患者中存在差異。新疆的民族分布特征與其他北方內(nèi)陸城市有一定差異,這可能是導(dǎo)致HCV基因型分布與以往報(bào)道的流行病學(xué)分布特征不一致的原因之一。6個(gè)基因型(1b,2a,3a,3b,6a,1b/2a型)在男女性別中的差異,各基因型構(gòu)成均無(wú)性別差異。但按性別分層統(tǒng)計(jì),結(jié)果顯示,男女性丙肝感染者中,分別在2a型、1b、2a型中漢、維、哈族構(gòu)成比有差異。這一差異可能與三個(gè)民族的生活習(xí)慣、受教育程度、貧富差距及種族基因型等因素有關(guān)。1b型HCV對(duì)肝臟的損傷要比其他亞型嚴(yán)重的多,且臨床上其對(duì)干擾素的治療方案和周期以及治療效果也不盡相同。了解HCV基因分型區(qū)域分布特征具有很重要的臨床及流行病學(xué)意義。對(duì)了解新疆地區(qū)丙型肝炎患者的HCV基因分型情況提供了重要資料,同時(shí)對(duì)于丙型病毒性肝炎的流行病學(xué)研究、判斷病情和預(yù)后及觀(guān)察抗病毒療效提供了寶貴的資源。
[Abstract]:Objective: to analyze the genotypes of HCV infected Chinese, Uygur and Kazakh in a third class hospital in Xinjiang. To understand the difference of the main genotypes of HCV infection among the three nationalities, HCV genotyping was detected by reverse transcription PCR amplification and reverse dot hybridization, and the Chinese and Uygur were preliminarily understood. The genotypic characteristics of HCV in Kazakh people infected with HCV are the basic study of HCV in Xinjiang. Methods: in 2014, the serum samples of Chinese, Uygur and Kazakh people infected with hepatitis C were collected from a third class hospital in Xinjiang, and the viral load was detected by fluorescence quantitative PCR. HCV genotyping was detected by PCR- reverse dot hybridization when the load was more than 1 脳 10 ~ 3 copies/ml. Results:. 669 serum samples of HCV infection were classified successfully by PCR- reverse dot hybridization. The detection rate was 97.4 / 662 / 669 and 6 genotypes were detected, which were 1b / 2a, 3a / 3a / 3b / 6a and 1b / 2a, respectively. Among them, 395 cases of 1b type (60.58) had a difference between Han, Uygur and Kazakh ethnic groups. 188 cases of type 28. 83a were distributed in Han, Uygur and Kazakh ethnic groups. The difference was statistically significant (P 0.05). There were differences in the composition ratio of Han, Uygur and Kazakh ethnic groups between male HCV infected patients and female HCV infected patients. The difference was statistically significant (P 0.05). The distribution of HCV type 2a in Han, Uygur and Kazakh nationalities was different in Urumqi. The difference was statistically significant (P 0.05). There was significant difference in the distribution of HCV 2a in Han, Uygur and Kazakh ethnic groups, and the difference was statistically significant (P0.05). In Kazakh nationality, the proportion of type 2a was higher than that of Han nationality, especially the rate of 2a. The distribution of Uygur cases with type .1b HCV infection was different among different clinical types. The difference was statistically significant (P 0.05). The proportion of 1b type in hepatitis C associated liver cancer was higher. The average RNA load of 83.33 and 1.1b was 1.41 脳 10 ~ 6 鹵1.43 脳 10 ~ 5 / ml. The average RNA load of type 2a was 7.84 脳 10 ~ 5 鹵1.43 脳 10 ~ 5 / ml. The difference was statistically significant (P 0.05). The load levels were 1.00 脳 10 ~ (4) ~ 9.99 脳 10 ~ (4) and 1.00 脳 10 ~ (7) ~ 9.99 脳 10 ~ (7), respectively, at 1 b. There was significant difference between type 2a and other types, and the difference was statistically significant (P0.050.Conclusion: 1b genotype was predominant in 652 cases of HCV infection in Xinjiang, followed by 2a type 1b. 2a was different in hepatitis C patients of Han, Uygur and Kazakh nationalities, and the ethnic distribution of Xinjiang was different from that of other inland cities in the north. This may be one of the reasons why the genotype distribution of HCV is not consistent with the epidemiological characteristics reported in the past. The difference of 1b / 2a) in male and female was not different in all genotypes, but according to sex stratification statistics, the results showed that the male and female infected with hepatitis C were in 2a / 2a / 2a respectively in Chinese and Chinese. The composition ratio of Kazakh nationality is different from that of the three ethnic groups. This difference may be related to the living habits and educational level of the three ethnic groups. The difference between the rich and the poor and the race genotype and other factors related to the damage of liver caused by type 1 b HCV was much more serious than that of other subtypes. It is very important to understand the regional distribution of HCV genotyping. It is very important to understand the type C liver in Xinjiang. The HCV genotyping of patients with inflammation provides important information. At the same time, it provides valuable resources for the epidemiological study of hepatitis C, to judge the condition and prognosis and to observe the antiviral effect.
【學(xué)位授予單位】：新疆醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2015
【分類(lèi)號(hào)】：R512.63

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