【摘要】 目的检测新疆地区丙型肝炎患者HCV-RNA水平并进行基因分型分析。方法 2015年7月至2017年10月石河子大学医学院第一附属医院感染性疾病科确诊的丙型肝炎患者153例,采集静脉血,采用RT-PCR法检测HCVRNA;采用ELISA法检测抗HCV抗体;采用PCR-反向点杂交法进行HCV基因分型,并比较不同传播途径HCV基因型及不同基因型丙型肝炎患者HCV-RNA水平和抗HCV水平;使用自动生化分析仪检测ALT和AST水平;使用血细胞分析仪检测Hb、PLT水平,并进行比较分析。结果 153例丙型肝炎患者共检出5种HCV基因型1b、2a、3b、3a和6a,以1b型所占比例较高,为60.13%;不同基因型HCV组丙型肝炎感染患者血HCV-RNA分别为(2.34±0.25)×103IU/mL,(1.35±0.14)×103 IU/mL,(1.62±0.17)×103 IU/mL,(1.29±0.13)×103 IU/mL和(1.44±0.15)×103 IU/mL,差异有统计学意义(FHCV-RNA=12.568,P<0.05)。不同基因型抗-HCV分别为(12.67±1.29)S/CO、(11.62±1.20)S/CO、(10.20±1.05)S/CO、(8.66±0.85)S/CO和(11.75±1.20)S/CO,差异有统计学意义(F抗HCV抗体=10.352,P<0.05);输血、血液透析、静脉药瘾、性途径及混合途径组1b所占比例分别为75.61%、71.88%、40.74%、50.00%和65.38%,与其他基因亚型组比较差异有统计学意义(P<0.05);感染不同HCV基因型组ALT、Hb、PLT比较有统计学意义(FALT=4.549,FHb=5.467,FPLT=9.310,P<0.05),AST水平差异无统计学意义(F=1.838,P>0.05);1b型组ALT、Hb、PLT分别为(77.50±7.81)U/L、(143.02±14.04)g/L和(169.98±16.93)109/L,与其他基因型组比较差异有统计学意义(P<0.05)。结论新疆地区丙型肝炎患者感染HCV基因型以1b为主,血中抗-HCV和HCV-RNA含量及ALT、Hb水平均与HCV基因型有关,可为丙型肝炎的个性化治疗提供参考依据。更多还原

【Abstract】 Objective To detect the level of HCV-RNA in patients with hepatitis C in Xinjiang and to analyze the results of genotyping. Methods Subjects were 153 patients with hepatitis C seen in Infectious Diseases in the First Hospital Affiliated with the Medical College of Shihezi University.The level of HCV-RNA in the serum of the subjects was detected using RT-PCR.The anti-HCV antibody titer was detected using ELISA.HCV genotyping was performed using PCR-reverse dot blot hybridization,and HCV-RNA levels and the anti-HCV antibody titer were compared among HCV genotypes with different routes of transmission and different genotypes from patients with hepatitis C.ALT and AST levels were measured using a biochemical analyzer,and the Hb level and PLT count were measured using a blood cell analyzer.Levels of ALT,AST,and Hb and the PLT count were compared and analyzed in different genotypes. ResultsFive genotypes were detected in 153 patients.The 1btype was most prevalent and accounted for 60.13%.Serum HCVRNA levels in patients infected with different HCV genotypes were 2.34±0.25×103 IU/mL,1.35±0.14×103 IU/mL,1.62±0.17×103 IU/mL,1.29±0.13×103 IU/mL,and 1.44±0.15×103 IU/mL,respectively.RNA levels differed significantly(FHCV-RNA=12.568,P<0.05).By genotype,the anti-HCV S/CO ratio was 12.67±1.29,11.62±1.20,10.20±1.05,8.66±0.85,and 11.75±1.20,respectively.The S/CO ratio differed significantly(Fanti-HCV antibody=10.352,P<0.05).Type 1bwas found in 75.61% of patients infected via a blood transfusion,71.88%infected during hemodialysis,40.74%infected as a result of intravenous drug use,50.00%infected as a result of sex,and 65.38%infected via multiple routes.Type 1bwas more prevalent than other sub-genotypes(P<0.05).There were significant differences in the ALT level,Hb level,and PLT count between different HCV genotypes(FALT=4.549,FHb=5.467,FPLT=9.310,P<0.05),and there was no significant difference in the AST level(F=1.838,P>0.05).The ALT and Hb levels and PLT count were higher in type 1bthan in a mixed genotype(P<0.05).The ALT level,Hb level,and PLT count were 77.50±7.81U/L,143.02±14.04g/L,and 169.98±16.93x109/L in type 1b;those values were higher than the ALT level,Hb level,and PLT count in other genotypes(P<0.05). Conclusion The HCV genotype in this region is mainly 1b.The serum anti-HCV antibody titer,HCV-RNA level,and levels of ALT and Hb are related to the genotype.This finding can provide a reference for personalized treatment of hepatitis C.更多还原