HBeAg阳性慢性乙型肝炎患者红细胞补体受体Ⅰ型分子基因点突变与HBV DNA含量的关系  

Relationship of spots mutation of complement receptor type 1 gene and the concentrations of HBV DNA in patients with e antigen positive

作　　者：罗丽莎[1] 张继万[1] 周建丽[1] 何鹏飞[1] 隆莉[1] 张晓芳[1] 赵志勇[1] 刘娴[1] 王海滨[2] 

机构地区：[1]武警四川总队医院感染科 [2]解放军第302医院临床检验医学中心

出　　处：《中华临床医师杂志（电子版）》2011年第7期1912-1916,共5页Chinese Journal of Clinicians(Electronic Edition)

摘　　要：目的研究免疫应答和耐受HBeAg阳性慢性乙型肝炎患者红细胞补体受体Ⅰ型分子(CR1)基因点突变与HBV DNA含量变化的关系,探讨其临床意义。方法选择肝脏功能正常、血清HBV DNA大于106IU/ml的114例HBeAg阳性慢性乙型肝炎患者作为免疫耐受组研究对象,选择初次发生转氨酶高于正常值2倍以上伴或不伴有肝细胞性黄疸的110例HBeAg阳性慢性乙型肝炎患者为免疫应答组研究对象。采用PCR和HindⅢ酶切技术对红细胞CR1分子基因多态性进行分类。用细胞核酸释放剂(CNR)裂解细胞,释放HBV DNA,对白细胞HBV DNA进行实时荧光PCR检测。结果免疫应答组HBeAg阳性慢性乙型肝炎患者的红细胞CR1基因点突变率明显低于免疫耐受组和正常人群(P<0.05)。在免疫应答组中,CR1基因发生点突变患者的血清和白细胞HBV DNA含量均明显高于未发生点突变者(P<0.05);在免疫耐受组中,红细胞CR1基因发生点突变和无点突变的患者其血清和白细胞HBV DNA差异均无统计学意义。结论检测HBeAg阳性慢性乙型肝炎患者红细胞CR1基因点突变对了解乙型肝炎患者清除HBV的能力、评估病情发展、判断预后具有一定的指导意义。Objective To study the relationship of spots mutation of complement receptor type 1(CR1) on erythrocytes and the concentrations of HBV DNA in serum and WBC in patients with e antigen positive of immune response and suppression. Methods 114 patients of e antigen positive with normal hepatic function and HBV DNA much more 106 IU/ml in serum have been studied in groups of immune suppression.110 cases of jaundice and ALT twice over normal level have been used in groups of immune response.Genomic density polymorphism of complement receptor type 1(CR1) on erythrocytes has been classified by polymerase chain reaction(PCR) and Hind Ⅲ restriction enzyme digestion.HBV DNA in WBC was isolated by cellular nucleic acid releaser (CNR).HBV DNA has been detected by real time quantitative PCR. Results The spots mutation rate of CR1 gene in immune responsive groups was obviously lower than that in immune suppressive groups and healthy individuals(P<0.05).In immune responsive groups,the HBV DNA concentrations in serum and white blood cells of patients with CR1 gene spots mutation were both significantly higher than that of patients with none of mutation(P<0.05).In immune suppressive groups,the concentrations of HBV DNA in serum and white blood cells of patients with CR1 gene spots mutation were not significantly different from that of patients with none of mutation. of CR1 in patients with chronic hepatitis B of e antigen positive may be important to realize the capability of clearing HBV and estimate the development and prognoses of diseases.

关 键 词：肝炎 乙型 慢性 红细胞 受体 补体 点突变 乙型肝炎病毒基因 

分 类 号：R512.62[医药卫生—内科学]