摘要
目的探讨乙型肝炎病毒前C区G1896A突变、基本核心启动子区A1762T、G1764A双突变与基因型、拉米夫定疗效的相关性。方法采用基因测序法对接受拉米夫定治疗的81例慢性重型乙型肝炎患者的血清标本进行前C区、基本核心启动子区(BCP区)、基因型及逆转录酶区(P区)检测,并对前C区、BCP区的变异与基因型、逆转录酶区的变异进行相关性分析。结果 81例慢性重型乙型肝炎患者送检标本中,68份标本可检出前C区G1896A变异或BCP区A1762T/G1764A变异;单纯G1896A突变31例,单纯A1762T/G1764A突变24例,前C区联合BCP区变异13例;81例慢性重型乙型肝炎患者经拉米夫定治疗后,有45例发生变异,其中180M和204V变异株35例,204I变异株10例;前C区变异在野生型组、变异型组中的检出率分别为38.9%、66.7%,两者差异有统计学意义(P<0.05);BCP区变异在野生型组、变异型组中的检出率分别为33.3%、55.6%,两者差异有统计学意义(P<0.05);在81例慢性重型乙型肝炎患者血清标本中,B基因型18例,C基因型63例;前C区变异在B、C基因型中的检出率分别为72.2%、33.3%,两者差异有统计学意义(P<0.05);BCP区变异在B、C基因型中的检出率分别为16.7%、54.0%,两者差异有统计学意义(P<0.05);G1896A突变在B基因型感染者中检出率明显高于C基因型感染者;A1762T/G1764A双突变在B基因型感染者中检出率明显低于C基因型感染者。结论发生G1896A突变和A1762T/G1764A突变的患者,在接受拉米夫定治疗后更易发生逆转录酶区的变异;G1896A突变易出现在B基因型感染者中,A1762T/G1764A突变易出现在C基因型感染者中。
OBJECTIVE To explore the relationship between the mutation of precore G1896A and double mutations of basic core promoters of A1762T and G1764A of hepatitis B virus and the genotypes as well as the efficacy of lamivudine.METHODS A total of 81 patients with chronic severe hepatitis B were enrolled in the study,then the precore region,basic core promoter region （BCP region）,genotypes,and reverse transcriptase region （P region） in the serum samples obtained from the patients were detected,and the relationship between the mutations of pre-core region and BCP region and the genotypes and variants of reverse transcriptase region were analyzed.RESULTS The mutation of precore region G1896A or BCP region A1762T/G1764A was detected in the samples of 68 of 81 patients with chronic severe hepatitis B,including 31 cases of single mutation of G1896A,24 cases of single muta-tion of A1762T/G1764A,and 13 cases of variant of precore region combined with BCP region.Of the 81 patients with chronic severe hepatitis B who were treated with lamivudine,45 cases had the variants,including 35 cases of variants in 180M and 204V and 10 cases of variants in 204 I.The detection rate of the precore region variant was 38.9% in the wild-type group,66.7% in the variant group,there was significant difference between the two＆amp;nbsp;groups （P〈0.05）;the detection rate of the BCP region variant was 33.3% in the wild-type group,55.6% in the variant group,with statistical significant （P〈0.05）.Among the 81 patients with chronic hepatitis B,there were 18 cases with genotype B tested positive in the serum samples and 63 cases with genotype C tested positive;the detection rate of the precore region variant was 72.2% in the genotype B,33.3% in the genotype C,with statisti-cal significant （P〈0.05）;the detection rate of the BCP region variant was 16.7% in the genotype B,54.0% in the genotype C,there was significant difference （P〈0.05）;the detection rate of the G1896A mutation was signif-icantly higher in the patients infected
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2015年第1期1-4,共4页
Chinese Journal of Nosocomiology
基金
国家自然科学基金资助项目(81170444)
天津市卫生局科技基金资助项目(10KG101)
