安康市常住丙型肝炎患者外周血HCV-RNA水平及基因分型

HCV-RNA level and genotype in peripheral blood of permanent residents with hepatitis C in Ankang city

目的了解安康市常住丙型肝炎患者外周血HCV-RNA水平及基因分型,为临床诊疗提供数据参考。方法选取2017年1月至2018年12月在陕西省安康市中医医院就诊的268例丙型肝炎患者作为研究对象,检测HCV基因分型、抗HCV抗体、HCV-RNA、ALT、AST及TBIL水平。比较各HCV基因型的人口学特征、抗HCV抗体、HCV-RNA、ALT、AST及TBIL水平。结果本次对268例丙肝患者的血样进行检测,共检测出1a、1a+1b、1b、2a、3a、3b、3a+6a、6a等8种基因型,还有部分未能进行分型(记为未分型)。其中1b型占比最高,其次为6a型,1a+1b型、2a型、3a型、3b型、3a+6a型占比较为接近,未分型占比最少。不同基因分型的丙肝患者的年龄、性别、文化程度、职业、感染途径比较,差异均无统计学意义(P>0.05)。不同基因型丙肝患者的抗HCV抗体、HCV-RNA水平比较,差异有统计学意义(P<0.05);1b型的抗HCV抗体及HCV-RNA水平显著高于其他基因型(P<0.05)。不同基因分型丙肝患者ALT水平比较,差异有统计学意义(P<0.05);不同基因分型丙肝患者AST、TBIL水平比较,差异无统计学意义(P>0.05);1b型的ALT水平显著高于其他基因型,差异有统计学意义(P<0.05)。结论安康市常住人口中的丙肝患者主要以1b型HCV病毒感染为主,且该型的HCV-RNA水平、抗HCV抗体、ALT水平显著高于其他基因型,可为临床诊疗提供参考。

Objective To understand the HCV-RNA level and genotype in peripheral blood of patients with hepatitis C in Ankang city, and to provide data reference for clinical diagnosis and treatment. Methods A total of 268 patients with hepatitis C treated in Ankang hospital of traditional Chinese medicine from January 2017 to December 2018 were selected as the study objects, and the levels of HCV genotype, anti-HCV antibody, HCV-RNA, ALT, AST and TBIL were detected. The demographic characteristics and levels of anti-HCV antibody, HCV-RNA, ALT, AST and TBIL of each HCV genotype were compared. Results The blood samples of 268 patients with hepatitis C were tested. Eight genotypes including 1a, 1a+ 1b, 1b, 2a, 3a, 3b, 3a+6a and 6a were detected, and others were not typed (denoted as untyped). Among them, type 1b accounted for the highest proportion, followed by type 6a. Type 1a + 1b, 2a, 3a, 3b, 3a + 6a accounted for the most similar proportion, and the proportion of untyped was the least. There were no significant differences in age, gender, education level, occupation and route of infection among different genotypes of patients with hepatitis C (P>0.05). The anti-HCV antibody and HCV-RNA level in different genotypes of patients with hepatitis C were significantly different (P<0.05);the anti-HCV antibody and HCV-RNA level of type 1b were significantly higher than those of other genotypes (P<0.05). There was significant difference in ALT level among different genotypes of patients with hepatitis C (P<0.05);there were no significant differences in the levels of AST and TBIL among different genotypes of patients with hepatitis C (P>0.05);the ALT level of type 1b was significantly higher than that of other genotypes (P<0.05). Conclusion The patients with hepatitis C in Ankang city are mainly infected with type 1b of HCV. The HCV-RNA level, anti-HCV antibody and ALT level of this type are significantly higher than those of other genotypes, which can provide reference for clinical diagnosis and treatment.