本文關(guān)鍵詞： HLA-DQB1 乙肝表面抗體 抗體親和力 年齡　出處：《大連醫(yī)科大學(xué)》2017年碩士論文　論文類型：學(xué)位論文

【摘要】：目的:觀察不同年齡人群乙肝表面抗體陽性率的差異,尋找HLA多態(tài)性與乙肝表面抗體水平的相關(guān)性。并利用對(duì)三個(gè)不同年齡組的乙肝表面抗體陽性的患者的抗體總活性、抗體親和力之間的比較,及抗體總活性和抗體親和力與血清生化指標(biāo)之間的關(guān)系,來找出影響乙肝表面抗體水平的因素。方法:本實(shí)驗(yàn)血清樣本來自大連醫(yī)大學(xué)附屬第一醫(yī)院和大連市兒童醫(yī)院的患者(乙肝表面抗體陽性,乙肝表面抗原陰性,乙肝核心抗體陰性,乙肝e抗體陰性,乙肝e抗原陰性),選取200例血清樣本,其中男性100例,女性100例。按年齡將樣本分為四個(gè)組:1-2歲組,男女各25例;6-8歲組,男女各25例;24-26歲組,男女各25例。6-8歲組乙肝表面抗體陰性對(duì)照組男女各25例。首先對(duì)6-8歲組的HLA-DQB1基因分型進(jìn)行檢測(cè)。用LIASON全自動(dòng)化學(xué)發(fā)光分析儀對(duì)乙肝表面抗體陽性的血清進(jìn)行一定比例的連續(xù)稀釋后檢測(cè),直到檢測(cè)稀釋樣本為陰性為止,經(jīng)線性轉(zhuǎn)化求得總活性和親和力。利用日立7180全自動(dòng)生化分析儀對(duì)四組血清進(jìn)行生化項(xiàng)目檢測(cè)。找出抗體總活性和抗體親和力與生化指標(biāo)之間的相關(guān)性。另選取70例血清樣本,進(jìn)行乙肝表面抗體中和表面抗原試驗(yàn),其中成年組(乙肝表面抗體陽性,乙肝表面抗原陰性,乙肝核心抗體陽性,乙肝e抗體陽性,乙肝e抗原陰性)35例,兒童組(乙肝表面抗體陽性,乙肝表面抗原陰性,乙肝核心抗體陰性,乙肝e抗體陰性,乙肝e抗原陰性)35例。結(jié)果:HLA-DQB1多態(tài)性與乙肝表面抗體水平無統(tǒng)計(jì)學(xué)關(guān)系。1-2歲乙肝表面抗體總活性與鐵蛋白,天門冬氨酸氨基轉(zhuǎn)移酶,血清總蛋白,血清白蛋白,血清尿酸,血清尿素氮,血清鈣離子,血清鎂離子,胱抑素C均有相關(guān)性。1-2歲乙肝表面抗體總活性與血清谷丙氨酸氨轉(zhuǎn)移酶,血糖,肌酐,磷,NT-proBNP無相關(guān)。1-2歲組抗體親和力與血清谷丙氨酸氨轉(zhuǎn)移酶,天門冬氨酸基轉(zhuǎn)移酶有相關(guān)性。1-2歲組抗體親和力與總蛋白,白蛋白,尿酸,血糖,尿素氮,肌酐,鈣,鎂,磷,胱抑素C,鐵蛋白,NT-proBNP無相關(guān)。6-8歲年齡組總活性與血清尿素氮,血清胱抑素C有相關(guān)性。6-8歲年齡組總活性與谷丙氨酸,天門冬氨酸,總蛋白,白蛋白,尿酸,血糖,肌酐,鈣,鎂,磷,鐵蛋白,NT-proBNP無相關(guān)。6-8年齡組親和力與血清谷丙氨酸氨基轉(zhuǎn)移酶,總蛋白,血糖,血尿素氮,血肌酐,血磷均有相關(guān)性。6-8年齡組親和力與谷丙氨酸,天門冬氨酸,白蛋白,尿酸,鈣,鎂,胱抑素C,鐵蛋白,NT-proBNP無相關(guān)性。24-26歲組總活性與血清白蛋白,血清鈣離子有相關(guān)性。6-8歲乙肝表面抗體陽性與陰性組血清尿酸,磷,白細(xì)胞是影響抗體產(chǎn)生因素。乙肝恢復(fù)期成人和健康兒童乙肝表面抗體活性存在顯著性差異。結(jié)論:同一水平的疫苗誘發(fā)的表面抗體的中和作用不及自然感染人群所產(chǎn)生的表面抗體,在不同年齡兒童中乙肝表面抗體陽性率和總活性也有所不同,可能和不同年齡的生理,營養(yǎng)和發(fā)育有關(guān)。
[Abstract]:Objective: to observe the difference of positive rate of hepatitis B surface antibody in different age groups, to find out the correlation between HLA polymorphism and hepatitis B surface antibody level, and to make use of the total antibody activity of three different age groups of patients with positive hepatitis B surface antibody. The comparison of antibody affinity and the relationship between total antibody activity, antibody affinity and serum biochemical indexes, Methods: the serum samples were collected from patients from the first affiliated Hospital of Dalian Medical University and Dalian Children's Hospital. Hepatitis B core antibody negative, hepatitis B e antibody negative, hepatitis B e antigen negative, 200 serum samples were selected, including 100 males and 100 females. According to their age, the samples were divided into four groups: 1 to 2 years old, 25 male and 25 male to 8 years old. 25 men and 25 women aged 24 to 26, There were 25 cases in male and 25 cases in group of 6-8 years old and 25 cases in negative control group. The HLA-DQB1 genotyping of group 6-8 years old was detected. LIASON automatic chemiluminescence analyzer was used to detect the positive serum of anti-HBV surface antibody. Ratio of continuous dilution after detection, Until the diluted sample is negative, The total activity and affinity were obtained by linear transformation. The biochemical items of four groups of serum were tested by Hitachi 7180 automatic biochemical analyzer. The correlation between the total activity of antibody and the affinity of antibody and biochemical index was found out. 70 serum samples were selected. The neutralizing surface antigen test of hepatitis B surface antibody was carried out. In adult group, 35 cases were positive for hepatitis B surface antibody, negative for hepatitis B surface antigen, positive for hepatitis B core antibody, positive for hepatitis B e antibody, and negative for hepatitis B e antigen. Children's group (hepatitis B surface antibody positive, hepatitis B surface antigen negative, hepatitis B core antibody negative, hepatitis B e antibody negative, Results there was no significant correlation between HLA-DQB1 polymorphism and HBV surface antibody level. Total activity of HBV surface antibody and ferritin, aspartate aminotransferase, serum total protein, serum albumin, serum uric acid in 1-2 years old were not significantly correlated with HLA-DQB1 polymorphism. Serum urea nitrogen, serum calcium ion, serum magnesium ion, cystatin C were all correlated. Total activity of hepatitis B surface antibody in 1-2 years old was correlated with serum glutamic alanine aminotransferase, blood glucose, creatinine. The antibody affinity of NT-proBNP was not correlated with serum glutamic alanine aminotransferase, aspartate aminotransferase was correlated with serum aspartate aminotransferase. In 1-2 years old group, antibody affinity was related to total protein, albumin, uric acid, blood glucose, urea nitrogen, creatinine, calcium, magnesium, phosphorus, The total activity of cystatin C, ferritin NT-proBNP was not correlated with serum urea nitrogen. The total activity of serum cystatin C was correlated with glutenin, aspartic acid, total protein, albumin, uric acid, blood glucose, creatinine, calcium, magnesium, and serum cystatin C, and the total activity of serum cystatin C was correlated with glutathione, aspartic acid, total protein, albumin, uric acid, blood glucose, creatinine, calcium, magnesium. The affinity of NT-proBNP was not correlated with serum glutamic alanine aminotransferase, total protein, blood glucose, blood urea nitrogen, serum creatinine and serum phosphorus. Uric acid, calcium, magnesium, cystatin C, ferritin NT-proBNP have no correlation. The total activity of NT-proBNP is correlated with serum albumin and serum calcium ion. WBC is the factor that affects antibody production. There is significant difference between adult and healthy children in hepatitis B surface antibody activity. Conclusion: the neutralization effect of surface antibody induced by the same level of vaccine is not as good as that of natural infection. The surface antibody produced by the group, The positive rate and total activity of HBsAg may be related to physiology, nutrition and development of children of different ages.
【學(xué)位授予單位】：大連醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R186

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