摘要
目的采用基因芯片检测徐州地区慢性HBV感染者病毒基因分型和耐药基因,并研究其应用价值及临床意义。方法收集徐州市传染病医院2015年5月—2017年7月在徐州市传染病医院肝炎科就诊的34例临床确诊为慢性HBV感染且有抗病毒药物应用史且治疗效果不佳患者的临床资料和患者的血清样本,采用基因芯片技术对样本进行乙肝病毒基因分型和耐药突变的检测,将检测结果结合患者的临床资料进行分析,判断其应用价值及意义并指导临床用药。结果 34例患者检出HBV DNA阳性为32例,阴性2例,阳性患者中HBV-C型患者26例,HBV-B型患者3例,HBV-B合并HBV-C患者3例;LAM+Ldt耐药4例,为2例C型、1例B型、1例B、C合并型;LAM+Ldt+ADV3例,均为HBV-C型患者;LAM+Ldt+ETV耐药患者5例,均为HBV-C型;总计12例耐药患者中含有rt L180M和rt M204I/V突变有8例,rt A181V/T突变有3例,1例为rt M204I/V+rt T184A/I/L/S/F/G突变,4例除rt L180M和rt M204I/V突变还出现rt S203G/I,还有1例rt L180M和rt S202G/I突变。结论采用基因芯片检测乙型肝炎患者的基因分型和耐药基因,具有重要的应用价值,对指导临床抗病毒治疗具有十分重要的意义。
Objective This paper tries to analyze the application and clinical significance of gene chip technology in detection of viral genotypes and resistances genes in chronic HBV infected patients in Xuzhou area. Methods Clinical data and serum samples of 34 patients with chronic HBV infection and antiviral medication history and poor treatment effect from hepatitis department of Xuzhou infectious diseases hospital from May 2015 to July 2017 were studied, detection of hepatitis B virus genotypes and drug resistance mutations by gene chip technology were carried out, the detection results combined with the clinical data of patients were analyzed, its application value and the significance were determined and the clinical therapy was guilded. Results 32 cases were HBV DNA positive among the 34 patients, 2 cases were negative, 26 cases of patients with type HBV-C, 3 cases of patients with type HBV-B, 3 cases of patients with type HBV-B and HBV-C. 4 cases of LAM＋Ldt resistance, 2 cases of type C, 1 case of type B, 1 case of type B and C. 3 cases of patients with LAM＋Ldt＋ADV, all of which were HBV-C type. 5 cases of patients with LAM＋Ldt＋ETV resistance were HBV-C type. A total of 8 cases of drug resistance patients containing rtL180 M and rtM204 I/V mutation in 12 cases, 3 cases of rt A181 V/T mutation, 1 case of rtM204 I/V＋rt T184 A/I/L/S/F/G mutation, 4 cases in rtL180 M and rtM204 I/V mutations as well as rtS203 G/I, and 1 case of rtL180 M and rtS202 G/I mutation. Conclusion Gene chip for genotyping and drug resistance genes in hepatitis B patients has important application value and is of great significance in guiding clinical anti-virus treatment.
出处
《中外医疗》
2017年第29期34-37,共4页
China & Foreign Medical Treatment
