新疆阿克苏地区慢性丙肝患者基因分型与肝脏相关指标

Relationship between genotyping and liver related indexes of patients with chronic hepatitis C in Aksu,Xinjiang

目的通过对慢性丙肝患者HCV基因分型、肝脏超声及肝功能指标检测,评估HCV基因分型分布与病毒RNA拷贝数及肝脏损伤相关指标的关系。方法对就诊阿克苏地区第一人民医院符合入组标准的新疆阿克苏地区维吾尔族丙肝105例患者进行HCV RNA拷贝数检测。采用荧光定量PCR方法进行HCV基因分型。采用全自动生化分析仪及配套商业化试剂盒,对丙氨酸氨基转移酶(ALT)、天门冬氨酸氨基转移酶(AST)、直接胆红素(DIBL)和总胆红素(TIBL)进行测定。彩色多普勒超声系统进行肝脏超声。结果105例丙肝患者基因分型结果显示,1b型46例,2a型41例,3a型8例,3b型8例,6a型2例。1b型为主要的HCV病毒分型,且在RNA拷贝数、AST和ALT水平、肝硬化患者比例较高。统计学分析显示,不同HCV病毒分型与HCV RNA拷贝数之间差异有统计学意义(P=0.032),且在AST和ALT水平方面,1b型、2a型与其他三种分型(3b型、3a型和6a型)差异有统计学意义(P<0.01)。此外,1b型、2a型与其他三种分型在正常肝、肝光点增粗、脂肪肝和肝硬化之间差异有统计学意义(P<0.01)。结论新疆阿克苏地区维吾尔族人HCV基因分型存在地域分布差异。HCV RNA拷贝数、肝脏损伤程度与不同HCV基因分型存在相关性,对指导当地人群丙肝临床诊断和治疗有重要意义。

Objective Though HCV genotyping,liver ultrasound and liver function indicators were used to assess the relationship between HCV genotyping,viral RNA copy number and liver damage related indicators in patients with chronic hepatitis C.Methods A total of 105 Uyghur hepatitis C patients in Aksu,Xinjiang were recruited in our hospital.All patients were carried out a test of HCV RNA copy number.HCV genotyping was performed by fluorescence quantitative PCR method.Fully automatic biochemical analyzer was used for alanine aminotransferase(ALT),aspartate aminotransferase(AST),direct bilirubin(DIBL)and total bilirubin(TIBL)by commercial kits.Color doppler ultrasound system was used for liver ultrasound.Results The genotyping results of 105 Uyghur hepatitis C patients showed that type 1b,2a,3a,3b and 6a were 46,41,8,8 and 2,respectively.Type 1b was the main type of HCV virus.The proportion of RNA copy number,AST and ALT levels,and liver cirrhosis were higher in patients with type 1b.Statistical analysis showed that there was a significant correlation between different HCV virus types and HCV RNA copy number(P=0.032).In terms of AST and ALT levels,there were significant differences between type 1b,type 2a and other genotypes(type 3b and type 3a and type 6a)(P<0.01).In addition,patients with normal liver,enlarged liver spots,fatty liver and cirrhosis have significant differences among type 1b,type 2a and other genotypes(P<0.01).Conclusion There are regional differences in HCV genotyping among Uygur people in Aksu,Xinjiang.HCV RNA copy number and degree of liver damage are correlated with different HCV genotypes,which is of great significance to guide the clinical diagnosis and treatment of HCV in local populations.