本文關(guān)鍵詞： 戊型肝炎 HEV 獻(xiàn)血者 輸血傳播　出處：《青島大學(xué)》2017年碩士論文　論文類型：學(xué)位論文

【摘要】：研究背景戊型肝炎病毒(Hepatitis E Virus,HEV)是引起戊型肝炎發(fā)病的病原體,主要在衛(wèi)生條件差的地區(qū)經(jīng)糞-口途徑傳播。HEV輸血感染在日本和英國已經(jīng)得到了證實,HEV經(jīng)輸血途徑傳播已成為一個嚴(yán)重的公共健康問題,受到國內(nèi)外越來越多的關(guān)注。現(xiàn)階段,HEV并未列入中國獻(xiàn)血者常規(guī)篩查指標(biāo),關(guān)于青島地區(qū)獻(xiàn)血者HEV感染情況缺乏相關(guān)研究。研究目的通過對獻(xiàn)血者進行調(diào)查,了解青島地區(qū)無償獻(xiàn)血人群中戊型肝炎病毒的流行情況,分析輸血傳播HEV的潛在危險性,探討谷丙轉(zhuǎn)氨酶(ALT)水平與HEV感染的相關(guān)性,分析比較重疊感染的戊型肝炎的人群特點,為預(yù)防HEV通過輸血途徑傳播提供參考。研究方法1、收集青島地區(qū)獻(xiàn)血者血樣,其中包括合格獻(xiàn)血者739例進行HEV的相關(guān)血清學(xué)指標(biāo)檢測(抗-HEV Ig G,抗-HEV Ig M,HEV Ag)并與833例單純ALT升高組比較分析獻(xiàn)血者HEV流行病學(xué)特點。2、收集乙肝感染獻(xiàn)血者血樣105份進行戊型肝炎病毒的相關(guān)血清學(xué)指標(biāo)檢測,與合格獻(xiàn)血者比較分析HEV重疊感染的血清學(xué)特點。研究結(jié)果739名合格的無償獻(xiàn)血者中抗-HEV Ig G陽性95例,陽性率12.86%;抗-HEV Ig M陽性6例,陽性率為0.81%;HEV Ag陽性1例,陽性率為0.14%。833名ALT升高的獻(xiàn)血者中抗-HEV Ig G陽性109例,陽性率13.09%;抗-HEV Ig M陽性7例,陽性率為0.84%;HEV Ag陽性1例,陽性率為0.12%。合格獻(xiàn)血者抗-HEV Ig G和Ig M檢出率與ALT升高者相比差異無統(tǒng)計學(xué)意義(p0.05)。40歲以上年齡段明顯高于低年齡段比例(χ2=12.967,P0.01)。在739份合格獻(xiàn)血者和833份單純的ALT升高的獻(xiàn)血者的血液中,有8例樣本是HEV Ig G和Ig M同時陽性,195例樣本是HEV Ig G單獨陽性,5例樣本是HEV Ig M單獨陽性,2例標(biāo)本為HEV抗原單獨陽性。隨機抽取的105例HBV感染患者中,HEV合并HBV感染患者20例,HBV感染者各年齡組的HEV Ig G陽性率均高于合格獻(xiàn)血者。合格獻(xiàn)血者和HBV感染者中HEV Ig G陽性率最高的職業(yè)都是農(nóng)民。研究結(jié)論青島地區(qū)是一個戊型肝炎流行地區(qū),獻(xiàn)血者中存在一定比例HEV感染者。ALT篩查對HEV的血液篩查作用不大,獻(xiàn)血者經(jīng)過常規(guī)血液篩查后,仍有輸血傳播HEV的潛在風(fēng)險。
[Abstract]:Background Hepatitis E virus (HEV) is the pathogen causing hepatitis E. Transmission of HEV through faecal-oral route has been confirmed to be a serious public health problem in Japan and the United Kingdom, mainly in areas with poor sanitary conditions. More and more attention has been paid at home and abroad. At this stage, HEV is not included in the Chinese blood donors routine screening indicators. There is a lack of relevant research on HEV infection among blood donors in Qingdao. Objective to investigate the prevalence of hepatitis E virus among blood donors in Qingdao. To analyze the potential risk of transfusion-transmitted HEV, to explore the correlation between alt level and HEV infection, and to compare the population characteristics of hepatitis E with superinfection. In order to prevent the transmission of HEV through blood transfusion. 1. Collect blood samples from blood donors in Qingdao. Among them, 739 eligible blood donors were tested for the relative serological indexes of HEV (anti-HEV IgG, anti-HEV Ig M). The epidemiological characteristics of HEV in blood donors were compared with those in 833 patients with elevated ALT. 105 blood samples from patients with hepatitis B infection were collected for the detection of hepatitis E virus related serological indexes. The serological characteristics of HEV superinfection were compared with those of qualified blood donors. The results showed that 95 of 739 eligible blood donors were positive for anti-HEV Ig G, the positive rate was 12.86%. Anti-HEV IgG M was positive in 6 cases, the positive rate was 0.81%. One case was positive for HEV Ag, and the positive rate was 0.14%. 109 cases were positive for anti-HEV IgG, the positive rate was 13.09%. Anti-HEV IgG M was positive in 7 cases, the positive rate was 0.84%. HEV Ag was positive in 1 case. The positive rate of anti-HEV IgG and IgM in qualified blood donors was 0.12. There was no significant difference between the positive rates of anti-HEV IgG and IgM in patients with elevated ALT (p 0.05). The proportion of age group over 40 years old was significantly higher than that of low age group (蠂 2 + 12.967). In 739 eligible donors and 833 simple elevated ALT donors, 8 samples were positive for both HEV IgG and IgM. 195 samples were HEV IgG positive alone and 5 samples were HEV IgM positive. Two samples were single positive for HEV antigen, and 20 of 105 HBV infected patients with HBV infection were randomly selected. The positive rate of HEV Ig G in all age groups of HBV infected persons was higher than that in qualified blood donors. The highest positive rate of G was found in farmers. Conclusion Qingdao is an epidemic area of hepatitis E. There is a certain proportion of blood donors infected with HEV. Alt screening has little effect on the blood screening of HEV. After routine blood screening, donors still have the potential risk of blood transfusion transmission of HEV.
【學(xué)位授予單位】：青島大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R512.6;R181.3

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