云南地区丙型肝炎病毒基因亚型及RNA载量在丙型肝炎进展中的变化
The Changes of Hepatitis C Virus Gene Subtypes and RNA Loads in the Development of Chronic Hepatitis C Patients in Yunnan
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摘要: 目的 检测云南地区慢性丙型肝炎、丙肝相关性肝硬化、丙肝相关性肝癌患者中丙肝病毒 (HCV) 的基因亚型及RNA载量在疾病进展过程中的变化.方法 通过收集2016年1月至2017年4月昆明医科大学第一附属医院及云南省传染病医院收治的患者241例, 其中丙型肝炎组患者169例, 丙肝相关性肝硬化组56例, 丙肝相关的肝癌组16例作为研究对象.采用PCR荧光探针法检测血清中丙肝病毒基因亚型以及HCV RNA载量.结果 在丙型肝炎患者中3b型最多 (27.81%) ;在丙肝相关性肝硬化患者中1b型最多 (30.36%) ;在丙肝相关性肝癌中3 b型最多 (31.25%) .3组患者基因亚型比例无显著差别 (P>0.05) .慢性丙型肝炎、丙肝相关性肝硬化、丙肝相关性肝癌组患者的HCV RNA载量分别为 (332±114) Copies/m L、 (189±73) Copies/m L、 (152±56) Copies/m L.3组患者HCV RNA载量的差异显著 (P<0.01) , 慢性丙型肝炎组高于其他2组 (P<0.01) , 但丙肝相关性肝硬化组与丙肝相关性肝癌组患者HCV RNA载量没有明显差别 (P>0.05) .结论 云南地区丙型肝炎中以3b型为主, 丙肝相关性肝硬化中以1b型为主, 丙肝相关性肝癌中3b型为主.在慢性丙型肝炎进展过程中HCV RNA载量减低.Abstract: Objective To investigate the changes of hepatitis C virus (HCV) gene subtypes and RNA loads in chronic hepatitis C, HCV-related liver cirrhosis and HCV-related hepatocellular carcinoma patients in Yunnan. Me thods 241 patients were enrolled at the First Affiliated Hospital of Kunming Medical University (Yunnan, China) from January 2016 to April 2017. Among them, 169 patients were with chronic hepatitis C, 56 patients with HCV-related liver cirrhosis and 16 patients with HCV-related hepatocellular carcinoma. HCV gene subtype and RNA loads were measured using the Polymerase Chain Reaction-fluorescence probe method. Re s ults In the chronic hepatitis C group, there were 47 subtype 3 b cases (27.81%) . 17 cases of HCV-related liver cirrhosis were subtype 1 b (30.36%) ;5 patients with HCV-related hepatocellular carcinoma were subtype 3 b (31.25%) .There was no statistical difference distribution of the genotype among the three groups (P>0.05) .The HCV RNA loads of the chronic hepatitis C group, HCV-related liver cirrhosis group and HCV-related hepatocellular carcinoma group were (332±114) copies/m L, (189±73) copies/m L and (152±56) copies/m L respectively.The difference among three groups were significant (P <0.01) .The chronic hepatitis C group was significantly higher than the other two groups, and the differences were statistically significant (P<0.01) . But no significant difference of HCV RNA loads was found between HCV-related liver cirrhosis and HCV-related hepatocellular carcinoma group (t = 0. 65, P<0.05) . Conclus ion In Yunnan, 3 b was main genotype in chronic hepatitis C patients and 1 b was main genotype in HCV-related liver cirrhosis, 3 b was main genotype in HCV-related hepatocellular carcinoma. HCV RNA loads tend to decrease in the progress that chronic hepatitis C develops into HCV-related liver cirrhosis and HCV-related hepatocellular carcinoma.
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[1] [1]THOMAS D L.Global control of hepatitis C:where challenge meets opportunity[J].Nat Med, 201 3, 19 (7) :850-858. [2]武海波, 周紫霄, 黄奕祥.2004-2011年中国丙型病毒性肝炎流行病学特征分析[J].现代预防医学, 2015, 42 (7) :1173-1175. [3]杨志国, 陈晓慧, 沈敏, 等.580例肝硬化住院患者病因分析[J].中国肝脏病杂志, 2014, 6 (3) :47-49. [4] [4]SIMMONDS P, BUKH J, COMBET C, et al.Consensus proposals for aunified system of nomenclature of hepatitis C virus genotypes[J].Hepatology, 2005, 42 (4) :962-973. [5]濮翔科, 申玉, 熊敏, 等.丙型肝炎病毒基因分型的基因芯片法检测[J].中国实用医药, 2012, 32 (7) :30-31. [6]中华医学会肝病学分会.中华医学会传染病与寄生虫学分会.丙型肝炎防治指南[J].中华预防医学杂志, 2004, 38 (3) :210-215. [7]黄艳秋, 史昌河.丙型病毒性肝炎基因分型及临床意义[J].青岛大学医学院学报, 2012, 48 (5) :468-470. [8] [8]ASHFAQ UA, JAVED T, REHMAN S, et al.An overview of HCV molecular biology, replication and immune responses[J].J Virol, 2011, 8 (6) :161-172. [9]杨伟国, 徐辉.甘肃省4个不同民族丙型肝炎病毒感染的基因型特征[J].甘肃中医学院学报, 2013, 30 (1) :27-30. [10]唐维, 苏明华, 江建宁, 等.广西地区丙型肝炎病毒的基因型分布与流行病学特征[J].世界华人消化杂志, 2014, 22 (9) :1300-1306. [11]龚韩湘, 吴泽墉, 伍宝玲, 等.我国吸毒人群丙型肝炎病毒感染情况的系统评价[J].中国慢性病预防与控制, 2017, 25 (8) :625-628. [12]李泽, 刘继政, 申元英.大理州吸毒人群HIV、HCV感染及相关高危因素调查[J].大理大学学报, 2016, 10 (1) :77-80. [13]张乾, 潘延凤, 平骁功, 等.HCVRNA载量在慢性丙肝, 肝硬化, 肝癌患者中的变化及基因分型[J].医药论坛杂志, 2014, 35 (2) :47-49. [14]张成成, 张立, 张文军.丙肝病毒基因组、免疫逃逸及其疫苗研究进展[J].广东药学院学报, 2015, 31 (5) :682-687. [15]张晋, 张娟, 薛晓宁, 等.血清HCV RNA载量、HCV抗体及ALT相关性研究[J].中国国境卫生检疫杂志, 2017, 40 (2) :83-86. [16]宋玉国, 郑艳, 黄建文, 等.HCV基因型与HCV感染者ALT的关系[J].中国实验诊断学, 1997, 1 (2) :29-30. [17]周友乾, 尹凤鸣, 冯经华.丙型肝炎病毒载量与基因型和抗病毒疗效的关系研究[J].实用肝脏病杂志, 2011, 14 (4) :340-343. [18]刘桂香, 田登, 杨维雄.西宁地区丙型肝炎的基因分型与药物治疗关系的研究[J].现代预防医学, 2008, 35 (4) :625-629. -
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