HBVDNA的初检含量及反弹性质与变异关系的研究  

Stndy on the relationship between the content and springback nature of HBV DNA primarily detected and the variations.

作　　者：潘智勇[1] 郑晓云[1] 陈然峰[2] 

机构地区：[1]温州医学院生物学实验教学中心,浙江温州325035 [2]武警浙江省总队医院检验科,浙江嘉兴314000

出　　处：《中国热带医学》2005年第1期12-13,3,共3页China Tropical Medicine

摘　　要：目的 探讨对慢性乙肝患者单用拉米夫定治疗前HBV DNA的含量和治疗过程中HBV DNA的反弹性质与变异的关系。 方法 采用单一拉米夫定治疗96例HBV DNA含量不同的慢性己肝患者,应用Taqman荧光探针技术和UniArray技术对治疗2.6、12、18个月后患者血清分别检测HBV DNA含量和YMDD位点突变。 结果 治疗前含量为大于7.5 × 105、7.5×106、7.5 × 107 copy／ml的乙肝患者,治疗6个月后YMDD变异率分别为0％(0／30)、3.1％(1／32)、5.9％(2／34),治疗18个月后YMDD变异率分别为16.7％(5／30)、31.3％(10／32)、50％(17／34)。根据HBV DNA含量的下降、波动、反弹将96例乙肝患者分三种类型:A类32例,HBV DNA含量呈线性下降,无YMDD基因突变;B类26例,HBV DNA含量先下降、后反弹、波动、再下降,无YMDD基因突变;C类38例,HBV DNA含量先下降、反弹、波动、再持续上升,其中32例YMDD基因突变。 结论 HBV DNA初检含量与变异有关,疗前HBV DNA含量愈高,疗后易发生YMDD变异。2至6个月HBV DNA波动小,而6个月后反弹明显的形成YMDD变异的潜在性大,2至6个月HBV DNA波动大,而6个月后反弹不明显的形成YMDD变异的潜在性小。Objective To study the relationship between HBV DNA first examination content, rebound quality and gene mutation. Methods 96 patients with different HBV DNA Content were treated by using Lamifudine, Contents of serum HBV DNA and YMDD mutation 2,6,12,18 months after treatment were determined by PCR-Fluorescense quantity and UniArray technique. Results The YMDD mutation rate in patients with,HBV DNA Content of 7.5 × 105,7.5 × 106,7.5 × 107(copy-ml) before treatment and 0%(0/30),3.1(1/32),5.9%(2/34) 6 months after treatment and 16.7% (5/30),31.3% ( 10/32),50.0% (17/34) 18 months after treatment respectively. 96 patients were devided into groups A, B and C according to reduction, fluctuation and rebounding of HBV DNA contents. Linear derease of contents of HBV DNA and mutation was observed in 32 cases in group A, contents of HBV DNA in 26 cases in group B was,first decreased,then rebounded,fluctuated and descended again,without gene mutation.Contents of HBV DNA in 38 cases in group C.was first decreased,then rebounded,fluctuatedand and continuously decreased. Gene mutation was observed in 32 cases. Conclution There was relationship between HBV DNA first examination contents and YMDD mutation,The mutation rate increased with the increasing HBV DNA concentration before treatment. Mutation rate in patients whose HBV DNA cont-tents undulated slightly from 2 to 6 monthes and then rebounded obviously after 6 monthes , or the possibility was low.

关 键 词：HBV 治疗 DNA含量 YMDD变异 初检 患者 基因突变 下降 种类 发生 

分 类 号：R512.62[医药卫生—内科学] R373[医药卫生—临床医学]