中小学生乙型肝炎病毒感染现状及其基因型分布特征研究
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摘要
目的了解深圳地区中小学生乙型肝炎病毒(HBV)感染现状及基因型分布情况,为HBV患者合理用药提供依据。方法选取2016年3月～2017年9月在深圳地区就读的中小学生4217名,采用酶联免疫吸附法(ELISA)检测学生血清中HBV表面抗原(HBVHBsAg),对HBsAg为阳性的学生,采用PCR法检测HBVDNA,对HBVDNA阳性标本采用PCR测序法对HBV基因型进行分析,并对结果进行统计分析。结果 4217名中小学HBV-HBsAgELISA法阳性率为6.28%(265/4217),其中男生为6.69%(137/2047),女生为5.90%(128/2170),男生略高于女生,但差异无统计学意义(χ~2=1.492,P>0.05),经PCR-DNA定量复检阳性230例,阳性符合率为86.79%(230/265),其中初中生阳性率为5.62%(124/2206),小学生为5.27%(106/2011),两者差异无统计学意义(χ~2=0.835,P>0.05)。HBVDNA阳性标本中B基因型检出率为61.30%(141/230),明显高于C基因型的24.35%(56/230),差异有统计学意义(χ~2=6.755,P<0.05),混合感染以B+C为主,感染率为12.17%(28/230);初中生和小学生HBV各基因型分布之间差异均无统计学意义(χ~2=0.573～1.132,P>0.05),男生和女生之间差异也均无统计学意义(χ~2=0.759～1.496,P>0.05)。结论深圳地区中小学生有一定的HBV感染率,B基因型为本区HBV感染的主要基因型,其次为C基因型,混合感染以B+C混合基因型为主。因此,加强HBV基因型分析对HBV合理用药具有重要的意义。
Objective:To understand the status of HBV infection and genotype distribution of HBV in shenzhen area,and to provide basis for rational drug use of HBV patients. Method:Selection in March 2016 to September 2017 in the shenzhen area of primary and middle school students,4217,by using enzyme-linked immunosorbent(ELISA)to detect students in serum HBV surface antigen(HBsAg)HBV,students of HBsAg positive by PCR method to detect HBV DNA,the HBV DNA positive specimens by PCR sequencing method to analyze HBV genotypes,and the results were analyzed. Results:4217 primary and secondary HBV-HBsAg ELISA method positive rate was 6.28%(265/4217),the boy was 6.69%(137/2047),the girl was5.90%(128/2170),boys slightly higher than the girls,but there was no statistically significant difference(χ~2=1.492,P>0.05),the quantitative PCR-DNA positive review of 230 cases positive coincidence rate was 86.79%(230/265),the positive rate was 5.62%(124/2206)in junior high school students,The primary school student is 5.27%(106/2011),and the difference between the two is not statistically significant(χ~2=0.835,P>0.05). HBV DNA positive specimens in type B gene detection rate was 61.30%(141/230),significantly higher than that of C genotype 24.35%(56/230),the difference was statistically significant(χ~2=6.755,P<0.05),mixed infection is given priority to with B + C,infection rate was 12.17%(28/230);The difference of HBV genotype distribution between junior high school students and primary school students was not statistically significant(χ~2=0.573～1.132,P>0.05),and the difference between male and female students was not statistically significant(χ~2=0.759～1.496,P>0.05). Conclusion:There is a certain HBV infection rate in primary and middle school students in shenzhen,and B genotype is the main genotype of HBV infection in this region,followed by C genotype,and mixed infection is mainly B+C mixed genotype. Therefore,strengthening HBV genotype analysis is of great significance for rational use of HBV.
Objective:To understand the status of HBV infection and genotype distribution of HBV in shenzhen area,and to provide basis for rational drug use of HBV patients. Method:Selection in March 2016 to September 2017 in the shenzhen area of primary and middle school students,4217,by using enzyme-linked immunosorbent(ELISA)to detect students in serum HBV surface antigen(HBsAg)HBV,students of HBsAg positive by PCR method to detect HBV DNA,the HBV DNA positive specimens by PCR sequencing method to analyze HBV genotypes,and the results were analyzed. Results:4217 primary and secondary HBV-HBsAg ELISA method positive rate was 6.28%(265/4217),the boy was 6.69%(137/2047),the girl was5.90%(128/2170),boys slightly higher than the girls,but there was no statistically significant difference(χ~2=1.492,P>0.05),the quantitative PCR-DNA positive review of 230 cases positive coincidence rate was 86.79%(230/265),the positive rate was 5.62%(124/2206)in junior high school students,The primary school student is 5.27%(106/2011),and the difference between the two is not statistically significant(χ~2=0.835,P>0.05). HBV DNA positive specimens in type B gene detection rate was 61.30%(141/230),significantly higher than that of C genotype 24.35%(56/230),the difference was statistically significant(χ~2=6.755,P<0.05),mixed infection is given priority to with B + C,infection rate was 12.17%(28/230);The difference of HBV genotype distribution between junior high school students and primary school students was not statistically significant(χ~2=0.573～1.132,P>0.05),and the difference between male and female students was not statistically significant(χ~2=0.759～1.496,P>0.05). Conclusion:There is a certain HBV infection rate in primary and middle school students in shenzhen,and B genotype is the main genotype of HBV infection in this region,followed by C genotype,and mixed infection is mainly B+C mixed genotype. Therefore,strengthening HBV genotype analysis is of great significance for rational use of HBV.
引文
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[2]崔艳,李艳,乔斌,等.武汉市乙型肝炎病毒基因型分布和P区耐药突变模式及两者相关性分析[j].检验医学与临床,2015(125):577-579.
[3]Liang TJ,Block TM,Mc Mahon BJ,et al.Present and future therapies of hepatitis B:from discovery to cure[J].Hepatology,2015,62(6):1893-1908.
[4]孙利红.PDCA循环式护理干预对慢性乙型肝炎患者生存质量的影响[J].现代中西医结合杂志,2016,25(30):3412-3414.
[5]吴爱芳.利用PDCA循环式护理干预慢性乙型肝炎患者的效果观察[J].生物技术世界,2014,89(10):97.
[6]李芒会,张利侠,李亚娥.肿瘤标志物检测对原发性肝癌早期诊断的分析[J].现代检验医学杂志,2014,29(3):149-151.
[7]袁明利,汪彬,李彬,等.乙肝患者HBV基因型及P区耐药突变研究[J].宁夏医学杂志,2014,36(12):1098-1100.
[8]潘涛.门诊乙肝患者和经拉米夫定治疗后乙肝患者基因分型和HBV P区耐药突变检测分析[J].山西医科大学学报,2012,43(1):4-6.
[9]王志剑,黄志东,邝永辉,等.河源地区乙肝病毒分型和耐药突变基因检测的应用[J].现代诊断与治疗,2016,27(10):1837-1838.
[10] He T,Jia J. hronic HBV:which pregnant women should be treated[J].Liver international,2016,36(1):105-108.
[11] Ozaras R,Inanc BI,Yemisen M,et al. Epidemiology of HBV subgenotypes D[J].Clin Res Hepatol Gastroenterol,2015,39(1):28-37.
[12] Carobene M,Bolcic F,FaHas MS,et al.HIV,HBV and HCV molecular epidemiology among trans(transvestites transsexuals,and transgender)sex workers in Argentina[J].J Med Virol,2014,86(1):64-70.
[13]廖乾秀.成都地区乙型肝炎病毒感染者病毒基因型和亚型分布及其临床意义[J].湖北民族学院学报·医学版,2016,33(3):43-45.
[14]付艳玲,余祖江.核苷类似物治疗慢性乙型肝炎耐药现状及进展[J].中国实用内科杂志,2015,35(4):370-373.
[15]郑志远.乙型肝炎基因分型同耐药位点突变的关系研究[J].国际检验医学杂志,2015,36(13):1905-1907.