摘要
目的分析瑞安地区慢性乙型肝炎核苷(酸)类药物治疗不应答患者血清中HBV P区变异情况和核苷(酸)类药物耐药情况。方法检测逆转录酶11个位点上的碱基突变情况,分析耐药基因耐药位点相关突变情况及不同核苷(酸)类药物的突变形式,根据位点变异情况,计算敏感性下降和耐药情况。结果检测202例乙型肝炎患者11个基因位点,其中54.46%发生1个或1个以上位点突变。突变的基因位点有173V、180L、181A、184T、202S、204M、236N,构成比分别为5.21%、25.52%、17.71%、3.13%、2.08%、39.06%、7.29%。另外P区耐药突变形式分析中,110例患者的样本在11个分析位点上共有17种突变模式。核苷(酸)类药物敏感性下降或耐药情况,202例乙型肝炎DNA中拉米夫定的耐药率最高,为45.05%,恩曲他滨、替比夫定、恩替卡韦、阿德福韦的耐药率分别为43.56%、34.65%、31.68%、10.89%,未发现替诺福韦的耐药株。结论阿德福韦和替诺福韦可作为核苷(酸)类药物治疗出现反弹的首选药物。
Objective Study the mutations of precore region and nucleoside drug resistance for chronic HBV patitents with ana- logue drug therapy does not answer in Rui＇ an area. Methods Detect 11 site base mutations in reverse transcriptase, analyze drug resistance - associated mutations site in genes and mutation form for nucleoside analogue, and according to the site muta- tion to calculate the drug resistance. Results 54.46% of the occurrence was with one or more sites of mutation in 11 sites of total 220 cases. Gene mutation had happened in 173V, 180L, 181A, 184T, 202S, 204M, 236N site, which were respectively 5.21% ,25.52% ,17.71% ,3.13% ,2.08% ,39.06% ,7.29% in these sites; There were 17 kinds of mutation patterns in 11 sites. Lamivudine resistance rates was up to 45. 05%, emtricitabine resistance was 43.56%, telbivudine resistance was 34.65%, entecavir resistance was 31.68%, adefovir resistance was 10.89% , and no tenofovir - resistant strains were found. Conclusion Adefovir and tenofovir may appear as the best choices for patitents with analogue drug therapy not answer in Rui＇ an.
出处
《中国卫生检验杂志》
CAS
2015年第8期1226-1228,1231,共4页
Chinese Journal of Health Laboratory Technology
