乙型肝炎病毒基本核心启动子及前C区突变对疾病进展的影响  

The influence of hepatitis B virus basic core promoter/precore mutations on adv ance of liver disease.

作　　者：房继莲[1] 丛旭[1] 李若冰[1] 许军[1] Erwin Sablon 孙焱[1] 王豪[1] 王宇[1] 魏来[1] 

机构地区：[1]北京大学人民医院,北京大学肝病研究所,100044 [2]Hepatitis Diagnostics Program,Innogenetic N.V.,Belgium

出　　处：《中国实用内科杂志》2005年第3期233-235,共3页Chinese Journal of Practical Internal Medicine

基　　金：国家"973"计划 (G19990 5 410 6)

摘　　要：目的　研究乙型肝炎病毒 (HBV)基本核心启动子 (BCP)T176 2 /A176 4双突变及前C区A1896突变与肝脏损伤程度的相关性。方法　 2 0 0 0～ 2 0 0 2年哈尔滨医科大学附属第二医院及广东省廉江市医院随机选取 113例慢性HBV感染者 ,采用INNO -LiPA法测定HBVBCPT176 2 /A176 4双突变及前C区A1896突变 ,同时测定HBVS基因序列明确基因型。结果　CHB组、LC组、HCC组BCPT176 2 /A176 4双突变率明显高于AsC组 (分别为 2 4 . 1%比 2. 8% ,χ2 =5 .93,P <0 . 0 5 ;71. 4 %比 2 .8% ,χ2 =2 3 .83,P <0 .0 1和 5 5 . 6 %比 2 .8% ,χ2 =13. 0 9,P <0 . 0 1) ,LC组BCPT176 2 /A176 4双突变率显著高于CHB组 (71 .4 %比 2 4 . 1% ,χ2 =9 .12 ,P <0 .0 1) ;单一C基因型感染者CHB、LC和HCC组BCPT176 2 /A176 4双突变率明显高于AsC组 (分别为 33 .3%比 5 . 3% ,χ2 =3 .89,P <0 .0 5 ;6 9 .2 %比5 . 3% ,P <0 . 0 1和 5 0 .0 %比 5. 3% ,P <0 . 0 5 )。各组前C区A1896突变率均较低 ,在CHB组和LC组无一例发生 ;HCC组前C区A1896突变率与AsC组比较差异无显著性 (11 .1%比 8. 3% ,χ2 =0 . 0 0 ,P >0 . 0 5 )。结论　在慢性HBV感染者中 ,BCPT176 2 /A176 4双突变与慢性肝病进展有关。Objective To investigate the relationship between hepatitis B virus (HBV) basic core promoter(BCP)/precore(PreC) mutations and severity of liver dis ease. Methods In 113 patients chronically infected with HBV, do uble mutations in BCP(T1762/A1764) and PreC mutation(A1896) were determined by INNO-LiPA and HB V genotype was determined by S gene sequencing. Results Whether in all patients or in patients infected by single genotype C, compared with AsC, the prevalence of double mutations in BCP(T1762/A1764) was higher in patients with CHB, LC and HCC[(24.1% vs 2.8%,χ 2=5.93, P<0.05; 71.4% vs 2.8%,χ 2=23.83, P<0. 01; 55.6% vs 2.8%,χ 2=13.09, P<0.01, respectively) and (33 .3% vs 5.3%,χ 2=3.89, P<0.05; 69.2% vs 5.3%, P<0.01; 50.0% v s 5.3%, P<0.05, respectively)]. Compared with CHB, the double mutations in BCP(T1762/A1764) was more common i n patients with LC(71.4% vs 24.1%,χ 2=9.12, P<0.01). Howev er, PreC mutatio n(single A1896) was not detected in patient with CHB and LC, and the prevalence of PreC mutation (single A1896) was low in patients with AsC and HCC(8.3% vs 11 . 1%,χ 2=0.00, P>0.05). Conclusions The doubl e mutations in BCP(T1762/A1764 ) may be related to progressive liver disease in patients with chronic HBV infec tion.

关 键 词：前C区 CHB LC 核心启动子 乙型肝炎病毒 HCC 疾病进展 BCP 廉江市 突变率 

分 类 号：R512.62[医药卫生—内科学] R735.7[医药卫生—临床医学]