乙型肝炎病毒基因变异与转氨酶和病毒复制量的关系探讨  

Preliminary study on the relationship among HBV-DNA mutation and the transaminase and quantity of HBV-DNA replication

作　　者：罗德生[1] 冯天芬[2] 崔小平[1] 巫贵成[2] 龙先利[3] 罗海峰[3] 

机构地区：[1]重庆三峡中心医院分子生物学室,404000 [2]重庆三峡中心医院肝病中心,404000 [3]重庆三峡中心医院生化科,404000

出　　处：《国际检验医学杂志》2006年第1期18-20,共3页International Journal of Laboratory Medicine

摘　　要：目的探讨乙型肝炎病毒基因变异与转氨酶和HBV-DNA复制量的关系。方法采用PCR熔解曲线法检测474例慢性乙型肝炎病毒感染者的酪氨酸-蛋氨酸-天冬氨酸-天冬氨酸(Tyrosine-Methionine-Aspartic acid-Aspartie acid,YMDD)变异,对171例患者(YMDD变异株42例、YMDD野生株66例、YMDD阴性63例)测定ALT与AST并进行HBV-DNA荧光定量检测。结果474例中检出YMDD变异63例,阳性率为13.3%(63/474),其中单一变异株82.5%(52/63),双突变株4.8%(3/63),共生变异株12.7%(8/63)。171例患者中YMDD变异株、YMDD野生株和YM-DD阴性与ALT及AST的异常情况分别为45.2%、53.0%、19.0%及42.9%、43.9%、17.5%,其含量分别为(150.1±185.6)U/L、(121.1±89.0)U/L、(32.5±30.6)U/L及(95.1±127.8)U/L、(89.9±86.8)U/L、(28.9±22.4)U/L。171例中YMDD变异株、YMDD野生株和YMDD阴性与HBV-DNA拷贝数的对数值分别为(6.89±0.99)拷贝/ml、(7.34±1.19)拷贝/ml、(2.89±0.48)拷贝/ml。结论(1)门诊肝病患者YMDD变异株阳性率为13.3%(63/474)。(2)ALT与AST在YMDD变异株与YMDD野生株之间无统计学意义(P>0.05);YMDD变异株与YMDD阴性之间有统计学意义(P<0.05)。(3)HBV-DNA荧光定量YMDD变异株与YMDD野生株之间无统计学意义(t=1.15,P>0.05),YMDD变异株与YMDD阴性之间有统计学意义(t=12.76,P<0.001)。(4)PCR熔解曲线法测定YMDD变异株与ALT和AST及HBV-DNA荧光定量联合检测对慢性乙型肝炎患者的诊断,治疗有极其重要的价值。Objective To discuss the relationship among the HBVDNA mutation and HBV-DNA replication quantity and hepatoenzymes. Methods YMDD mutation from 474 serum specimens in chronic hepatitis B patients were detected by PCR melting curve. ALT and AST were detected and HBV-DNA fluorimetry quantitative detection was performed in 171 patients （YMDD mutation 42, YMDD ferinus 66,YMDD negative 63）. Results YMDD mutation postive rate was 13.3%（63/474） in which single of YMDD mutation were 82.5% （52/63）, both variants were 4.8 % （3/63）, mixed variants were 12.7%（8/63）. YMDD mutation,YMDD ferinus and YMDD negative in 171 serum samples and abnormal ALT and AST were 45.2%,53.0%,19.0% and 42.9%,43.9%,17.5% respectively; in which the quantity of ALT were（150.1±185.6）U/L, （121.1±89.0）U/L, （32.5±30.6）U/L and （95.1± 127.8）U/L, （89.9±86.8）U/L, （28.9±22.4）U/L respectively. YMDD mutation and YMDD ferinus and YMDD negative in 171 serum samples with HBV-DNA Logarithm value of copies/ml were （6.89±0. 99） copies/ml,（7.34±1.19）copies/ml, （2.89±0.48）copies/ml. Condusion （1）YMDD mutation postive rates of the hepatopathy department patients was 13.3%（63/474）. （2） ALT and AST between YMDD mutation and YMDD ferinus , there was no difference（P〉0.05） ;between YMDD mutation and YMDD negative, there was statistical difference （ P〈 0. 05 ）. （ 3 ） HBV-DNA fluorimetry quantity between YMDD mutation and YMDD ferinus compared, there was no difference （t= 1.15, P〉0.05） ,between YMDD mutation and YMDD negative, there was significant difference（t= 12.76,P 〈0. 001）. （4）YMDD mutation of PCR melting curve and ALT and AST and HBV-DNA fluorimetry quantitative assay play an important role in the diagnosis and treatment of chronic hepatitis B.

关 键 词：变异(遗传学) 肝炎病毒 乙型 基因 病毒 病毒复制 

分 类 号：R512.62[医药卫生—内科学] R241.6[医药卫生—临床医学]