丙型肝炎病毒单基因型感染与非单基因感染患者基因型分析

Genotype analysis of hepatitis C virus single genotype infection and non-single gene infection

摘要:

目的 研究慢性丙型肝炎患者基因型分布情况，并对相关基因型进行血清学指标分析。方法 收集安徽省立医院感染病院114例慢性丙型肝炎患者血清样本，采用聚合酶链反应（PCR）-荧光探针法对患者丙型肝炎病毒进行分型，利用实时荧光定量PCR检测外周血丙肝病毒核糖核酸（HCV-RNA），同时检测肝功能[谷氨酸氨基转移酶（ALT）、天门冬氨酸氨基转移酶（AST）、γ-谷氨酰转移酶（GGT）]、凝血指标 [凝血酶原时间（PT）、凝血酶原活动度（PTA）、血小板（PLT）]及自身抗体[抗核抗体（ANA）、抗U1小核糖核蛋白抗体（抗RNP）、抗狼疮细胞抗体（抗Sm）、抗52?kD的多肽条段（抗Ro-52）、着丝粒蛋白B抗体（抗CENP B）、M2型线粒体抗体（AMA-M2）、抗肝/肾微粒体1型抗体（LKM1）]等相关血清学指标。结果 在114例慢性丙型肝炎患者中，丙型肝炎病毒基因型主要为1b型（80.70%），2a型（7.01%），6a型（1.75%），未分型（0.88%）。除了单基因型，还发现非单基因型11例（9.65%）。对单基因型和非单基因型相关实验室指标分析发现，非单基因型ALT及自身抗体检测阳性率要高于单基因型（Z?=1.999，P?=0.045；χ2=13.408，P?= 0.000），而对AST、GGT、PT、PTA、PLT等指标，单基因型与非单基因型患者比较，差异无统计学意义（P?>0.05）。结论 该研究的丙型肝炎病毒感染的患者中，丙型肝炎病毒基因型以1b为主；非单基因型对肝损害要高于单基因型，自身抗体出现的阳性率也更高，可能也更易出现自身免疫性疾病。

Abstract:

Objective To study the distribution of hepatitis C virus (HCV) genotype and to analyze the related serological indexes. Methods Serum samples were collected from 114 patients with hepatitis C in our hospital. The HCV genotype and HCV-RNA load were detected by PCR - fluorescence probe and fluorescence PCR method. Meanwhile, liver function (ALT, AST, GGT), coagulation indexes (PT, PTA, PLT), auto-antibody (ANA, anti-RNP, anti-Sm, anti-Ro 52, anti-CENP B, AMA-M2, LKM1) detection and other laboratory indicators were detected. Results The most common genotype was 1b (80.70%), followed by 2a (7.01%), 6a (1.75%) and undifferentiated type (0.88%). In addition to single genotype, there were 11 cases of non single genotypes else (9.65%). The analysis of serological indexes for single genotypes and non single genotypes showed that ALT and the positive rate of auto-antibody in non single genotype group were higher than that in single genotype group (Z?= 1.999, P?=?0.045; χ2=?13.408, P?=?0.000). However, AST, GGT, PT, PTA and PLT showed no significant difference between single genotype and non single genotype (P?>?0.05). Conclusions The 1b genotype is the main genotype. The liver damage of non single genotypes is higher than that of single genotypes, and is also more prone to autoimmune diseases.