动物医学进展
動物醫學進展
동물의학진전
PROGRESS IN VETERINARY MEDICINE
2015年
2期
134-137
,共4页
张军%肖越胜%范前东%王月萍%董玉颖%徐勤
張軍%肖越勝%範前東%王月萍%董玉穎%徐勤
장군%초월성%범전동%왕월평%동옥영%서근
戊型病毒性肝炎%多因素分析%核酸检测%基因分析
戊型病毒性肝炎%多因素分析%覈痠檢測%基因分析
무형병독성간염%다인소분석%핵산검측%기인분석
Hepatitis E%case-control study%multivariate analysis%nucleic acid detection%genetic analysis
为探讨人群戊型肝炎病毒（HEV ）感染与家畜 HEV 感染的流行病学关联性，揭示戊肝发病的危险因素，以134例戊肝患者为病例组进行1∶2配对病例对照研究，对收集与家畜相关的卫生行为资料采用多因素COX回归分析戊肝发病的危险因素，同时采集研究现场的家养猪、鸡粪便、猪胆囊、猪肝、环境水样等进行 HEV核酸检测，并对病例和猪肝阳性样本进行基因分析。多因素COX回归分析结果显示，猪类接触史（O R＝7．21，95％ C I：1．65～31．45）、生食瓜果蔬菜史（O R＝2．95，95％ C I：1．19～7．36）有统计学意义，研究现场的猪粪、猪胆囊、猪肝H E V核酸阳性检出率分别为10．2％、23．5％、30．8％，其余样本均为阴性。人和猪感染的H E V以基因4型为主，核苷酸同源性89．9％～99．3％。结果表明猪类接触史、生食瓜果蔬菜史是戊肝的危险因素，猪胆囊、猪肝的 HEV含量高，猪能通过猪粪排出HEV ，本地区人源和猪源 HEV同源性高，猪是本地人群HEV的重要宿主动物；应结合戊肝的流行特点开展相关防制工作，加强戊肝防控的健康教育和重点人群的保护。
為探討人群戊型肝炎病毒（HEV ）感染與傢畜 HEV 感染的流行病學關聯性，揭示戊肝髮病的危險因素，以134例戊肝患者為病例組進行1∶2配對病例對照研究，對收集與傢畜相關的衛生行為資料採用多因素COX迴歸分析戊肝髮病的危險因素，同時採集研究現場的傢養豬、鷄糞便、豬膽囊、豬肝、環境水樣等進行 HEV覈痠檢測，併對病例和豬肝暘性樣本進行基因分析。多因素COX迴歸分析結果顯示，豬類接觸史（O R＝7．21，95％ C I：1．65～31．45）、生食瓜果蔬菜史（O R＝2．95，95％ C I：1．19～7．36）有統計學意義，研究現場的豬糞、豬膽囊、豬肝H E V覈痠暘性檢齣率分彆為10．2％、23．5％、30．8％，其餘樣本均為陰性。人和豬感染的H E V以基因4型為主，覈苷痠同源性89．9％～99．3％。結果錶明豬類接觸史、生食瓜果蔬菜史是戊肝的危險因素，豬膽囊、豬肝的 HEV含量高，豬能通過豬糞排齣HEV ，本地區人源和豬源 HEV同源性高，豬是本地人群HEV的重要宿主動物；應結閤戊肝的流行特點開展相關防製工作，加彊戊肝防控的健康教育和重點人群的保護。
위탐토인군무형간염병독（HEV ）감염여가축 HEV 감염적류행병학관련성，게시무간발병적위험인소，이134례무간환자위병례조진행1∶2배대병례대조연구，대수집여가축상관적위생행위자료채용다인소COX회귀분석무간발병적위험인소，동시채집연구현장적가양저、계분편、저담낭、저간、배경수양등진행 HEV핵산검측，병대병례화저간양성양본진행기인분석。다인소COX회귀분석결과현시，저류접촉사（O R＝7．21，95％ C I：1．65～31．45）、생식과과소채사（O R＝2．95，95％ C I：1．19～7．36）유통계학의의，연구현장적저분、저담낭、저간H E V핵산양성검출솔분별위10．2％、23．5％、30．8％，기여양본균위음성。인화저감염적H E V이기인4형위주，핵감산동원성89．9％～99．3％。결과표명저류접촉사、생식과과소채사시무간적위험인소，저담낭、저간적 HEV함량고，저능통과저분배출HEV ，본지구인원화저원 HEV동원성고，저시본지인군HEV적중요숙주동물；응결합무간적류행특점개전상관방제공작，가강무간방공적건강교육화중점인군적보호。
To explore the epidemiological relevance of Hepatitis E Virus infection in human and livestock revealing risk factors of hepatitis E .The data of health behaviors related with livestock analyzed by multi‐variate COX regression analysis were collected by 1∶2 matched case‐control study of 134 patients in case group .Samples of the faece of pig and chicken ,pig gallbladder ,pig liver and environmental water in study site were collected tested by nucleic acid detection with positive samples of the patient and pig for genetic a‐nalysis .Multivariate analysis indicated that significant differences were found in history of exposure to pigs (OR=7 .21 ,95% CI :1 .65~31 .45) and history of eating raw fruits and vegetables (OR=2 .95 ,95%CI :1 .19~7 .36) between the case and control group .The rate of positive detection of the faece of pig ,pig gallbladder ,and pig liver was 10 .2% ,23 .5% and 30 .8% respectively .The HEV infected in human and pig was mainly genotype 4 with nucleotide homology of 89 .9% ~99 .3% .The result indicated that history of exposure to pigs and eating raw fruits and vegetables were risk factors of HEV infection and HEV could be discharged by pig faece with high titer in pig gallbladder and liver .The homology of HEV between hu‐man and pig was high indicating pig as a host animal of Hepatitis E possibly in the locality .Prevention work combined with epidemic characteristic should be implemented while strengthening the education of preventing Hepatitis E and protection of key population .
