【作者】 李志宾；

【导师】 蒋莹；

【作者基本信息】 新疆医科大学 ， 内科学， 2010， 硕士

【摘要】 目的:探讨丙型肝炎病毒(HCV)基因型及亚型在乌鲁木齐地区的分布特点及流行优势株、基因型在年龄、民族、性别、丙型肝炎感染途径、肝病严重程度、HCV RNA载量、ALT水平的意义等方面进行观察和分析以探讨HCV基因分型的意义,为临床制定治疗方案和判断预后提供参考依据。方法:在82份抗HCV抗体和HCV RNA均阳性的血清标本中,分别提取HCV RNA,通过PCR-反向点杂交法进行基因分型检测。同时收集病人的一般资料、感染途径、肝功能等资料进行登记。应用SPSS 17 for windows软件,进行统计分析,计量资料应用t检验,计数资料应用χ2检验。结果:1. 82例抗HCV抗体和HCV RNA阳性标本中,有78例可进行基因分型,其中1(1b)型47例占60.26%,2(2a)型16例占20.51%,3型(3a8例,3b 5例)占16.67%,6(6a)型2例占2.56%。2.≤50岁和>50岁基因型总体分布差异经χ2检验有统计学意义(χ2=13.183,P=0.004<0.05)。3. HCV基因型维、汉两民族中的分布差异经χ2检验没有统计学意义(χ2=0.729,P=0.866>0.05)。4. HCV基因型在女性、男性间的分布差异经χ2检验没有统计学意义(χ2=4.422,P=0.219>0.05)。5.经χ2检验,在HCV感染的不同肝病程度患者的基因型分布有统计学意义(χ2=23.052,P=0.001<0.05)。6.经χ2检验,HCV基因型与感染途径有显著性差异(χ2=60.270,P=0.000<0.05)。7.通过不同基因型之间ALT、HCV RNA载量对比分析,经单因素方差分析,基因型之间ALT水平有显著差异(F=4.539,P=0.014<0.05)。经单因素方差分析,基因型之间HCV RNA载量无显著差异(F=2.059,P=0.135>0.05)。结论:乌鲁木齐地区流行的HCV基因型为1(1b),2(2a),3(3a、3b),6(6a)4型,1型为流行的主要基因型,2,3,6型均占相当比例,初步说明乌鲁木齐地区HCV流行的基因型呈现多样性。更多还原

【Abstract】 Objective: To study the distribution of HCV genotypes and subtypes in Urumqi area and to know the relationship between HCV genotype and age, nationality, sex, hepatitis C transmission, severity of hepatopathy, serum load of HCV RNA and level of ALT. Methods: HCV RNA extracted from the Serum specimens of 82 patients with anti-HCV and HCV RNA positive was amplified by PCR, and then test the genotype of HCV RNA by using reverse dot-blot. At the same time, the general data of the patients, the transmission approach, liver functions were registered.We applicated SPSS 17 for windows to statistic analysis, t test for measurement data andχ2 test for numeration data. Results: 1. 82 Serum specimens from HCV infected patients were examined.78 Serum specimens can be genotyped for HCV RNA. In 78 Serum specimens, 60.26%(47/78), 20.51%(16/78), 16.67%(13/78) and 2.56%(2/78) belong to genotype 1(1b), genotype 2(2a), genotype 3(3a、3b) and genotype 6(6a). 2. The different on the distribution of HCV genotypes was significant between≤50years old and >50years old(χ2=13.183,P=0.004<0.05). 3. There had no significant difference between the Han nationality and the Uygur nationality(χ2=0.729, P=0.866>0.05). 4 .The difference was not statistically significant between female and male(χ2=4.422, P=0.219>0.05). 5.χ2 test, The distributions of genotype in different level of hepatopathy with HCV infected was statistically significant(χ2=23.052, P=0.001<0.05).6. Analyze relation between HCV genotype and route of infection. The distributions of genotype had significant difference(χ2=60.270 , P=0.000<0.05). 7. Contrastively analyze ALT level and quantitation of HCV RNA in different genotypes, through one-factor analysis of variance, there was significant different of ALT levels in different genotypes(F=4.539, P=0.014<0.05).There was not significant different of quantitation of HCV RNA in different genotypes(F=2.059, P=0.135>0.05). Conclusions: The HCV genotypes found in Urumqi area are 1, 2, 3, and 6. HCV genotype 1 is the main genotype, and genotypes 2, 3, and 6 accounts for some proportions, that interpret the diversity of HCV genotype in Urumqi.更多还原