单中心38例维持性血液透析患者乙型肝炎病毒感染基因型分布及同源性分析临床医学内科学(肾病)专业论文.docx

汕头大 汕头大学硕士学位论文 II II Distribution of Genotypes and Homology Analysis of Hepatitis B Virus from 38 Patients on Maintenance Hemodialysis in Single Center ABSTRACT Objective: To investigate genotype distribution of hepatitis B virus (HBV) on maintenance hemodialysis patients in the hemodialysis center of the second people’s hospital of Shenzhen; to analysis relativity between genotype and HBV DNA levels、HBV serum markers、liver function, and explore the impact on clinical manifestation; to find evidence of HBV nosocomial infection through molecular level, and to provide scientific evidence for preventing HBV infection. Methods: Serum specimens and clinical data were collected from maintenance hemodialysis patients, serum alanine aminotransferase and serum albumin was searched nearly three months through hospital electronic medical record, HBV serum markers and HBV DNA was detected, HBV S gene was obtained by polymerase chain reaction (PCR) amplifying and sequencing by dideoxy termination method; the gene sequences were analyzed and the polygenetic tree was drawn by the software MEGA 5.1. Results: Serum HBsAg positive rate was 20.77%（38 cases） among 183 patients. HBV DNA was positive in 24 serum samples, of these, 13(54.17％) were genotype B, 11(45.83％) were genotype C. HBV DNA level、HBeAg positive rate、serum alanine aminotransferase of genotype C was 5.93±1.98、54.55%、36.67±24.01, respectively, higher than 4.86±2.05、30.77%、21.52±10.11 of genotype B. HBeAb positive rate of genotype C was lower than genotype B, difference was all statistically nonsignificant; Polygenetic analysis revealed that evolutionary distance and similarity was 0.000 and 100% between 2 HBV-DNA S genes.which pointed out the same nucleotide sequence, epidemiological analysis revealed that one of them was new infection, whom be the same nurse operate when hemodialysis at the same time 100 times with another patient whom infect HBV between hemodialysis. Conclusions: HBsAg positive rate is 20.77% in the ce