乙型肝炎病毒C基因启动子和前C终止变异与乙型肝炎标志物模式的关系及临床意义  

Significance and relationship between mode of HBV marker and mutations in core promoter and precore gene of hepatitis B virus

作　　者：曹利[1] 张汉荣[1] 孙梅[1] 谈国蕾[1] 

机构地区：[1]东南大学医学院附属南京第二医院肝病研究室,江苏南京210003

出　　处：《临床荟萃》2005年第2期61-63,共3页Clinical Focus

摘　　要：目的　研究乙型肝炎病毒C基因启动子和前C基因终止变异与乙型肝炎标志物模式的关系 ,并分析其临床意义。方法　通过基因测序法分析检测 10 4例乙型肝炎患者血清中C基因启动子和前C基因终止变异情况 ,采用微粒子发光分析法和荧光定量聚合酶链法 (PCR) ,分别检测血清中乙型肝炎e抗原 (HBeAg)和乙型肝炎病毒脱氧核糖核酸 (HBV DNA)含量 ,并进行比较分析。结果　乙型肝炎表面抗原 (HBsAg)、HBeAg、乙型肝炎核心抗体 (抗 HBc)阳性患者 176 2T/176 4A双变异率显著高于HBsAg、乙型肝炎e抗体 (抗 HBe)、抗 HBc阳性患者 ,而 1896G→A终止变异率和联合变异 (双变异合并终止变异 )率显著低于HBsAg、抗 HBe、抗 HBc阳性组 ,73例HBsAg、HBeAg、抗 HBc阳性患者中 32例无变异者 ,其HBeAg定量值显著高于其他有变异者 ,31例HBsAg、抗 HBe、抗 HBc阳性患者中有 4例无双变异和终止变异 ,其HBV DNA定量值显著低于其他患者。结论　 176 2T/176 4A双变异和 1896G→A终止变异可使HBeAg含量显著下降 ,其变异株并不影响病毒的复制。 176 2T/176 4A双变异和 1896终止变异株的优势积累并逐渐取代野生株是HBeAg向抗抗Objective To study the significance and the relationship between the mode of HBV marker and mutations in the core promoter(CP) and the precore gene of hepatitis B virus(HBV). Methods CP and precore gene were sequenced directly from sera of 104 patients with hepatitis B. Serum HBeAg concentration was determined by microparticle enzyme immumo-assay and HBVDNA quantity was determined by PCR quantitative method. Results The rate of mutations in the CP of the patients with HBsAg/HBeAg/HBcAb positive was significantly higher than that in the patients with HBsAg/HBeAb/HBcAb positive.But the rate of mutation in the precore and the CP in patients with HBsAg/HBeAg/HBcAb positive was significantly lower than that in the patients with HBsAg/HBeAb/HBcAb positive. The HBeAg concentration in 32 patients without mutations was significantly higher than the others in 72 patients withHBsAg/HBeAg/HBcAb positive.The HBVDNA quantities in 4 patients without mntations in CP and the precore/core were significantly lower than the others in 31 patients with HBsAg/HBeAg/HBcAb positive. Conclusion The mutations in the CP and in the precore gene of hepatitis B virus can decrease the HBeAg concentration and can not change the copies of virus.One reason of converting from HBeAg to HBeAb is that the mutational strain will replace wild strain.

关 键 词：肝炎 乙型 C基因启动子 变异 肝炎E抗原 乙型 DNA 

分 类 号：R512.6[医药卫生—内科学]