摘要
目的HBV基因型与HBV传播方式、临床疾病谱、疾病进展、病情预后、以及抗病毒疗效均有一定的相关性,本研究拟进一步探讨HBV感染者基因型的临床意义。方法对我院162例HBV感染者进行HBV基因型分析,并对其肝功能、乙型肝炎病毒血清标志物(包括前-S1抗原)、HBV DNA定量和T细胞亚群等进行检测和分析。结果HBV基因型存在地域分布,北方人基因型以C型为主,南方人基因型以B型为主。在无症状携带者或急性肝炎-慢性肝炎-肝硬化-肝癌的进展顺序中,基因型B的比例逐渐减少,而基因型C的比例则逐渐增多。基因型C和BC混合型的前白蛋白水平(前-A)、白蛋白水平(ALB)以及白蛋白/球蛋白比例(A/G)较基因型B显著降低(分别为P=0.03、P=0.03、P=0.01和P=0.005、P=0.001、P<0.001),基因型C的胆碱酯酶(CHE)水平较基因型B降显著低,基因型C和BC混合型的球蛋白水平(GLO)较基因型B显著增加(分别为P<0.001和P=0.013);而在ALT、AST、TBil、GGT、ALP和TBA水平则差异不显著(P>0.05)。基因型C和BC混合型的HBV感染者中,前-S1抗原阳性率较高(分别为71.3%和66.7%),而基因型B的则低(阳性率30%);相反,基因型B的HBV感染者前-S1抗原阴性率高(66.7%),而基因型C和BC混合型的前-S1抗原阴性率低(分别为26.6%和25.9%)。结论HBV感染者的HBV基因型存在地域分布,基因型C较基因型B的肝功能损害严重,进展为慢性肝炎、肝硬化、肝癌的比例高。基因型C的前-S1抗原阳性率较高,基因型B的前-S1抗原阴性率高,它们的相关关系有待进一步研究。
Objective Previous studies showed that HBV genotypes correlated with HBV transmission,clinical disease spectra,progression,prognosis,antiviral effect,etc.This study is aimed to evaluate the clinical significance of HBV genotypes.Methods HBV genotypes were analyzed in 162 patients infected with hepatitis B virus.Liver function,HBV markers including pre-S1,HBV DNA levels and T cell subsets of these patients were also measured.Results HBV genotypes had a geographical distribution.Genotype C was mainly prevalent in patients from north of China while genotype B from south of China.In the progression of asymptomatic carrier or acute hepatitis to chronic hepatitis,liver cirrhosis and liver cancer,genotype C increased while genotype B decreased.Genotype C and genotype BC showed lower levels in prealbumin（pre-A）,albumin（ALB）and lower ratio of albumin to globulin（A/G） than genotype B（P=0.03,P=0.03,P=0.01 and P=0.005,P=0.001,P0.001,respectively）,but showed higher levels in globulin（GLO） than genotype B（P0.001 and P=0.013,respectively）.Genotype C showed lower levels in cholinesterase（CHE） than genotype B（P=0.007）.There was no significant difference among HBV genotypes in the levels of alanine transferase（ALT）,aspartate transferase（AST）,total bilirubin（TBil）,gamma-glutamyl transferase（GGT）,alkaline phosphatase（ALP）,total bile acid（TBA）.The positive rates of pre-S1 antigen of genotype C and genotype BC were high（71.3% and 66.7%,respectively） while those of genotype B was low（30%）.On the contrary,genotype C（26.6%） and genotype BC（25.9%） indicated lower negative rates of pre-S1 antigen than genotype B（66.7%）.Conlusions HBV genotypes had a geographical distribution.Genotype C showed more serious liver dysfunction than genotype B and was easier to develop into chronic hepatitis,liver cirrhosis and liver cancer.Further study was needed to know why genotype C has high pre-S1 positive rate while genotype B has high pre-S1 negative rate.
出处
《中华实验和临床感染病杂志（电子版）》
CAS
2007年第4期216-219,共4页
Chinese Journal of Experimental and Clinical Infectious Diseases(Electronic Edition)
