摘要
目的通过研究乙型肝炎患者HBV基因型的分布及YMDD变异位点的分布特点,了解两者之间的关系,探讨临床意义。方法选取在我院门诊和住院部就诊的HBeAg阳性并经拉米夫定治疗两年以上的慢性乙型肝炎患者137例,用实时荧光PCR方法检测HBV DNA分型情况,用LDR方法检测YMDD位点变异情况。结果 137例患者中21例未能检测出基因型,其中男性17例,女性4例;其余116例标本确定了感染病毒的基因型,包括男性94例,女性22例;其中A型2例(1.72%)、B型19例(16.38%)、C型91例(78.45%)、D型4例(3.45%);分型成功率为84.67%(116/137)。116例标本中有41例患者的感染病毒中检测到了YMDD变异位点,变异发生率为35.35%。其中B基因型中检出7例(36.84%);C基因型中检出33例(36.26%);D基因型中检出1例(25.0%);A基因型中未检测出变异位点。B、C基因型中变异位点的检出率高于D型,但各基因型之间差异无统计学意义(χ2=1.392,P>0.05)。在41例变异中,其中I突变占60.9%,V突变占31.7%,I/V共生突变占7.4%。结论兰州大学第一医院所在地区患者中HBV基因型主要以C型为主,其次是B型,也有少量D、A型存在;B、C基因型的YMDD位点发生突变的几率相近。突变几率与基因型无关。
Objective To investigate the distribution of hepatitis B virus（HBV） genotypes and determine the correlation with YMDD mutations present in those HBV genomes.Methods One-hundred-and-thirty-seven patients with chronic HBV infections and HBV e antigen（HBeAg）-positivity were recruited for study between February 2008 and January 2009.HBV genotypes were detected by real-time PCR,and YMDD mutations were detected by ligase detection reaction（LDR）.Results Twenty-one of the 137 specimens were unsuccessful in genotyping.For the remaining 116 specimens,two（1.7%） were genotype A,19（16.4%） were genotype B,91（78.5%） were genotype C,and four（3.5%） were genotype D.YMDD mutations were detected in 41（35.4%） of the specimens,including seven（36.8%） of genotype B,33（36.3%） of genotype C,and one（25.0%） of genotype D.Mutation rates were higher in genotypes B and C than in genotype D,but the differences did not reach statistical significance（χ2=0.034,P〉0.05）.Among the 41 viruses carrying the YMDD mutation,60.9% were classified as I mutation,31.7% as V mutation,and 7.4% as I/V mixed mutation.Conclusion The most frequent HBV genotype in our hospital’s chronic HBV population is genotype C,followed by genotype B.The YMDD mutation rates in genotypes B and C were similar,and the mutation rate was not correlated with the genotype.
出处
《临床肝胆病杂志》
CAS
2012年第6期428-430,共3页
Journal of Clinical Hepatology
基金
吴阶平医学基金会资助项目(LDWMF-SY-2011B006)
