摘要
目的分析邢台地区丙型肝炎患者病毒基因型分布特征,及其与疾病进展程度和持续病毒学免疫应答(SVR)的关系,为其预后判断提供依据。方法选取2010年12月-2014年12月邢台市人民医院收治的邢台地区丙型肝炎患者231例,收集患者一般资料,测定ALT、AST、白细胞(WBC)、基因分型及病毒载量。计量资料采用方差分析,计数资料采用χ2检验进行统计学分析。结果231例患者中1b亚型109例(47.2%),其次为2a亚型89例(38.5%),不同基因型患者的性别分布差异有统计学意义(χ2=13.461,P=0.009);不同基因型患者间HCV RNA载量差异有统计学意义(F=3.176,P=0.034),其中1型的病毒载量明显高于2型和3型;不同基因型患者间肝病严重程度差异有统计学意义(P<0.001),1b型患者中进展为肝硬化和肝癌的比例高于其他基因型;基因型为2型的患者治疗后获得SVR率为93.1%,远高于1型患者的69.4%,差异有统计学意义(χ2=19.850,P<0.001);112例(48.5%)患者出现了快速病毒学应答(RVR),其中96.4%最终产生SVR,未产生RVR的病例中64.7%最终产生SVR,两组SVR率比较差异有统计学意义(χ2=36.407,P<0.001);169例患者出现了完全早期病毒学应答(c EVR),其中88.8%最终产生SVR,未产生c EVR病例中56.5%最终产生了SVR,两组SVR率比较差异有统计学意义(χ2=29.684,P<0.001)。结论邢台地区丙型肝炎患者以1b亚型为主,其次为2a亚型。不同基因型患者性别、HCV RNA载量、SVR及肝病严重程度存在明显差异,丙型肝炎患者治疗前进行基因型分析对患者治疗、疾病进展以及预后有重要临床意义。RVR及c EVR等过程性病毒学应答指标对SVR有良好的指向性,产生这些病毒学应答的患者有较大概率获得SVR。
Objective To analyze the distribution characteristics of hepatitis C virus （HCV） genotypes in Xingtai, China, and their relationship with disease progression and sustained virologic response （ SVR）, and to provide a basis for the prognostic judgment. Methods A retrospective analysis was performed among 231 patients with hepatitis C who lived in Xingtai and were newly diagnosed and treated in our hospital from December 2010 to December 2014. In those patients, general information was collected, and alanine aminotransferase, aspar- tare aminotransferase, white blood cell, genotype, and viral load were determined. Continuous data were analyzed using analysis of variance, and categorical data were analyzed using x^2 test. Results In all patients, patients with 1 b subtype accounted for the highest proportion （ n = 109, 47.2% ）, followed by patients with 2a subtype （ n = 89, 38.5% ）. There was significant difference in gender distribution between patients with different genotypes （x^2= 13. 461, P = 0. 009 ）. There was significant difference in HCV RNA load between patients with differ- ent genotypes （ F = 13. 461, P = 0. 034）. Particularly, patients with type 1 HCV had a significantly higher viral load than patients with type 2 or 3 HCV. There was also significant difference in severity of liver disease between patients with different genotypes （ P 〈 0. 001 ）. Particu- larly, the incidence rate of cirrhosis or liver cancer in patients with type 1 b HCV was higher than that in patients with other genotypes. The incidence of SVR was significantly higher in patients with type 2 HCV than type 1 HCV （93.1% vs 69.4 %, x^2 = 19. 850, P 〈0. 001 ）. In all patients, 112 （48.5%） had a rapid virologic response （ RVR）, and there was significant difference in the incidence of SVR between patients with and without a RVR （ 96.4% vs 64.7%, x^2 = 36. 407, P 〈 0. 001 ）. In all patients, 169 had a complete early virologic response （eEVR） , and there was significant difference in the i
出处
《临床肝胆病杂志》
CAS
2015年第11期1845-1848,共4页
Journal of Clinical Hepatology
