抗HBe阳性乙型肝炎和无症状携带者的HBVC基因启动子和前C基因变异  

Analysis of the mutations in the core promoter and the precore gene of hepatitis B virus in patients with chronic hepatitis B positive for anti-HBe and asymtomatic carriers

作　　者：张汉荣[1] 刘新钰[1] 孙梅[1] 钟备[1] 赵巍[1] 曹利[1] 李敏[1] 

机构地区：[1]南京市第二医院肝病研究室,210003

出　　处：《江苏医药》2004年第12期884-887,共4页Jiangsu Medical Journal

基　　金：铁道部医学科研基金资助课题 (J99Z13 8)

摘　　要：目的　研究抗HBe阳性乙型肝炎病人和抗HBe阳性无症状携带者 (AsC)的乙型肝炎病毒 (HBV)C基因启动子 (CP)和前C基因变异。方法　通过DNA扩增、基因序列分析检测 34例抗HBe阳性和 5 5例抗HBe阴性乙型肝炎病人及 2 8例抗HBe阳性AsC的血清HBVCP和前C基因序列。结果　 (1 )抗HBe阳性肝炎组的前C终止变异 (nt1 896G→A)的发生率显著高于抗HBe阴性肝炎组 (6 1 8%和 1 4 5 %) ;而CP双变异 (nt1 76 2A→T和 1 76 4G→A)则在两组中无明显差异 (5 0 0 %和4 5 5 %) ;(2 )同抗HBe阳性AsC组比较 ,抗HBe阳性肝炎组的HBVDNA定量呈高水平 ,前C终止变异的发生率也显著增高 (6 1 8%和 2 8 6 %) ;(3)同抗HBe阳性慢性乙型肝炎 (CHB)组比较 ,抗HBe阳性重型乙型肝炎 (CSH)病人的前C终止变异发生率和CP双变异发生率无明显差异 (70 0 %和5 8 3%,5 0 0 %和 5 0 0 %) ,HBVDNA定量也无明显差异 ,而CPnt 1 75 2A→G变异发生率则显著增高 (80 0 %和 2 9 2 %)。结论　前C终止变异、nt1 84 6突变和病毒复制可能与抗HBe阳性乙型肝炎发病有关 ;而Cpnt1 75 2突变则可能与抗HBe阳性CSH发病有关。Objective To study the mutations in the core promoter(CP)and the precore gene of hepatitis B virus(HBV)in patients with chronic hepatitis B positive for anti-HBe.Methods CP and precore gene were sequenced directly from sera of 34 patients with chronic hepatitis B(CH) positive for anti-Hbe(group A),55 patients with (CH)negative for anti-HBe(group B) and 28 asymtomatic carriers positive for anti-HBe(group C),after amplification by the polymerase chain reaction.Results Precore mutant in nt1896(G→A)was observed in 21 of 34 cases of group A(61.8%),in 8 of 55 cases of group B(14.5%)and in 8 of 28 cases of group C(28.6%).The difference was significant.There was not significant difference in the prevalence of the double mutations (a A→T mutation at nt1762 and a G→A mutation at nt1764)between groups A and B(50.0% vs 45.5%,the prevalence of precore mutant in nt1896 in group A was also significantly higher than that of group C(61.8% vs 28.6%).The mutation in nt1752(A→G)was present in 8 of 10 of patients with chronic severe hepatitis B positive for anti-HBe(80.0%)and in 7 of 24 of patients with anti-HBe positive CH(29.2%).Conclusion Precore mutation in nt1896 and viral replication may be related to chronic hepatitis B positive for anti-HBe.The mutation in nt1752 may be associated with chronic severe hepatitis B positive for anti-HBe.

关 键 词：抗HBE阳性 前C基因 CP 发生率 无症状携带者 病人 乙型肝炎 变异 DNA扩增 基因序列分析 

分 类 号：R512.62[医药卫生—内科学] R259.126.2[医药卫生—临床医学]