浙江省乙型肝炎病毒B、C基因型感染者临床和肝组织病理的比较  

Association of histological liver damage with genotypes of HBV DNA in chronic hepatitis B patients in Zhejiang

作　　者：陈公英[1] 邵俊斌[1] 徐岱[1] 陈洁[1] 黄劲松[1] 余吉仙[1] 谢蕾[1] 刘春涛[1] 俞哲[1] 吴惟一[1] 

机构地区：[1]杭州市第六人民医院,310014

出　　处：《中华传染病杂志》2006年第2期113-115,共3页Chinese Journal of Infectious Diseases

基　　金：杭州市科技局资助项目(2005633022)

摘　　要：目的了解浙江省乙型肝炎病毒B、C基因型慢性HBV感染者的肝组织病理学变化。方法采用荧光PCR方法检测浙江省慢性乙型肝炎患者HBV基因型,并与慢性肝炎的肝功能、凝血酶原时间、乙型肝炎病毒标志、HBV DNA定量、肝组织炎症分级及纤维化分期进行比较。结果1.浙江省HBV基因型B型、C型占94.53%;2.C基因患者HBeAg阳性率及HBV DNA定量略高于B基因患者82.00%vs77.36%;(7.09±1.02)lg vs(6.88±1.26)lg,但差异无统计学意义(P>0.05);3.肝组织学炎症分级和纤维化分期以B、C混合型为重,C型重于B型,B型、C型、B+C型肝组织学炎症分级分别为1.85±1.27vs1.93±1.32vs2.93±0.74;纤维化分期分别为1.86±1.31vs1.84±1.29vs2.95±0.71,三者差异有统计学意义(P<0.01)。结论浙江省HBV基因型以B、C型为主,C型、BC混合型肝组织损害严重。Objectives We aimed to study the association of hepatitis B virus （HBV） genotypes, and histological liver damage in chronic hepatitis B in Zhejiang. Methods A real-time Fluores cence PCR for detecting HBV DNA genotypes was established and the HBV DNA genotypes of 128 chronic HBV infected patients were determined. Meanwhile, liver biopsy specimens of all patients were performed and histological activity index was scored for grade of necroinflammation and stage of fibrosis. Furthermore, HBV DNA was determined by a real time Fluorescence Quantitative PCR and immunoassay for the in vitro qualitative determination of serum HBsAg and HBeAg was tested. Resuits This new real time Fluorescence PCR can help to determine HBV genotypes clearly and directly with variable and accurate result. Of 128 HBV DNA positive patients who lived in Zhejiang province, 53 sample （41.40%） are type B, 50 sample （39.06%） are type C. 18 sample （14.06%） are type B＋ C. The HBeAg positive rate and HBV DNA title are mildly higher in patients with genotype C （82.00% and 7.09% 1.02 log10） than in patients with genotype B （77.36% and6.88± 1.26 log 10）. Significant difference was not found （P 〉 0.05）. Genotype B ＋C（ 2.93 ±0.74 and 2.95 ±0.71 ） was associated with higher grade of necroinflammation and stage of fibrosis than genotype B（ 1.76 ± 1.18 and 1.76±1. 15） andC（1.93±1. 32and 1.84±1.29） HBV. Conclusions genotype C or B＋C HBV are associated with more severe liver damage in patients. Stratification for HBV genotypes should be considered in the antiviral treatment of chronic hepatitis B.

关 键 词：肝炎 乙型 慢性 基因型 聚合酶链反应 肝 

分 类 号：R512.6[医药卫生—内科学]