乙型肝炎病毒基因型与拉米夫定治疗效应关系研究  

Research on relation between genotype and effect of lamivudine in patient with hepatitis B virus infection

作　　者：张红河[1] 邵听军[1] 杨仲国[1] 

机构地区：[1]杭州市第一人民医院基因诊断实验室

出　　处：《中国临床药理学与治疗学》2004年第9期1050-1053,共4页Chinese Journal of Clinical Pharmacology and Therapeutics

摘　　要：目的 :探讨乙型肝炎病毒基因型与拉米夫定治疗效应的关系。方法 :采用DNA测序和寡核苷酸芯片技术 ,检测分析了 4 1例使用拉米夫定治疗的乙型肝炎患者的基因型与酪氨酸 蛋氨酸 天冬氨酸 天冬氨酸 (YMDD)变异情况 ,同时跟踪观察了患者治疗前、治疗后 3、6、9、12个月的乙型肝炎病毒 (HBV)DNA和丙氨酸转氨酶 (ALT)水平。结果 :4 1例HBV患者中B基因型 2 1例 (5 1.2 % ) ,C基因型 2 0例(48.8% ) ;拉米夫定治疗前与治疗 12个月后B基因型与C基因型两组间ALT水平差异无显著性 (P >0 .0 5 )。拉米夫定治疗乙型肝炎过程中C基因型HBVDNA转阴率显著高于B基因型 ,B基因型HBVDNA反跳率显著高于C基因型 (P <0 .0 1)。C基因型YMDD突变率与B基因型差异无显著性 (P >0 .0 5 )。结论 :HBV基因型与拉米夫定治疗效应存在一定的相关性 ,C基因型对拉米夫定的治疗效应较好。AIM: To investigate the relation between the genotype and the effect of lamivudine in patient with hepatitis B virus infection. METHODS: The genotype of hepatitis B virus and the YMDD mutation of 41 chronic hepatitis B patients with lamivudine treatment were detected and analyzed by DNA sequencing and oligochip technology. The DNA of HBV and the levels of ALT were detected before therapy and after 3, 6, 9, and 12 months with lamivudine treatment. RESULTS: 21 samples were classified as genotype B ( 51.2%) and 20 as genotype C ( 48.8%) in 41 samples. There were no significant differences on the levels of ALT between genotype B and C before and after lamivudine treatment for 12 months (P> 0.05). After lamivudine treatment, the rate of the transform negative of HBV DNA in genotype C was significantly higher than that in genotype B, and the rate of the bounce of HBV DNA in genotype B was higher than that in genotype C (P< 0.01). There were no significant difference on the rate of mutation in YMDD betmeen genotype B and C (P> 0.05). CONCLUSION: There may be a relation between the effect of lamivudine and the genotype of Hepatitis B virus. The effect of the lamivudine treatment may be better in the patients with genotype C.

关 键 词：肝炎病毒 乙型 基因型 拉米夫定 治疗效应 

分 类 号：R978.7[医药卫生—药品]