慢性乙肝YMDD变异患者肝纤维化指标、血清标志物的检测及意义  

Detecting of the hepatic fibrotic indexes and serous markers from patients with chronic hepatitis B(CHB) and variation of HBV DNA YMDD

作　　者：王瑜敏[1] 陶志华[1] 朱燕英[1] 林晓梅[1] 

机构地区：[1]温州医学院附属第一医院实验诊断中心,浙江温州325000

出　　处：《临床肝胆病杂志》2007年第3期174-176,共3页Journal of Clinical Hepatology

摘　　要：探讨慢性乙肝患者(CHB)发生YMDD变异后肝纤维化指标及血清标志物的变化意义。检测接受拉米夫定治疗285例CHB患者YMDD变异情况,根据结果分为无突变组和突变组;又各分为继续使用拉米夫定治疗组和未继续治疗组;并测定各组乙肝病毒拷贝数(HBV-DNA)、乙肝两对半(HBV M)、常规肝功能指标、透明质酸(HA)、Ⅲ型前胶原(PCⅢ)、Ⅳ型胶原(C IV)水平。结果显示285例患者中发生YMDD突变144例,以Y IDD型最常见;突变组HBeAg阳性率、HBV-DNA水平高于无突变组(P<0.01、P<0.05);无突变病例中继续治疗组C IV、PCⅢ、HBV-DNA水平比未继续治疗组出现下降(P<0.01、P<0.05)。YMDD突变组HBeAg阳性率、病毒拷贝数高于无突变组,而纤维化指标无差异;继续使用拉米夫定治疗,可改善无突变组患者肝组织纤维化。To Study variation and clinical significance of the hepatic fibrotic indexes and serous markers form patients with chronic hepatitis B(CHB) and variation of HBV DNA YMDD.The 285 patients with the diagnose of CHB were detected for YMDD mutation.According to the results,the cases were divided into mutation group and nonmutation group.Moreover,they were further separated into therapy group treated with lamivudine and control group.HBV-DNA,HBV M,ALT,AST,GGT,HA,PCⅢ and CⅣ were studied.The HBV DNA YMDD sequence of 144 cases mutated compared with the control group.The HBeAg positive rate and the level of HBV DNA of mutation group were higher than those of nonmutation group(P<0.01,P<0.05).While the PⅣ、PCⅢ、HBV DNA of therapy group from the YMDD nonmutation cases decreased evidently.The HBeAg positive rate and HBV DNA were probably related to the YMDD mutation.The use of lamivudine might ameliorate fibrosis of the hepatic tissue form nonmutation cases.

关 键 词：慢性乙肝 YMDD变异 肝纤维化 血清乙肝标志物 

分 类 号：R512.6[医药卫生—内科学]