重型肝炎时乙型肝炎病毒基因型与基本核心启动子及前C区突变关系的研究  

Relationship between hepatitis B virus genotypes and basic core promoter/precore mutations in patients with severe hepatitis

作　　者：许正锯[1] 杨红[1] 陈先礼[1] 沈建坤[1] 张启华[2] 王崇国[1] 

机构地区：[1]解放军第180医院南京军区临床肝病中心一病区,福建泉州362000 [2]解放军第180医院南京军区临床肝病中心肝病中心实验室,福建泉州362000

出　　处：《中华实验和临床病毒学杂志》2006年第3期229-231,共3页Chinese Journal of Experimental and Clinical Virology

摘　　要：目的探讨重型肝炎(重肝)乙型肝炎病毒(HBV)基因型与基本核心启动子(BCP)及前C区突变的关系。方法采用聚合酶链反应(PCR)-限制性片段长度多态性分析技术(PCR-RFLP)对52例重肝和52例慢性乙肝(CHB)进行HBV基因分型。采用PCR产物直接测序技术,随机对15例B型和15例C型重肝患者的BCP区和前C区进行序列测定,分析HBV基因型与BCPT1762/A1764及前C区A1896突变的关系。结果泉州地区重肝的基因型以B型为主(48.08%),其次为C型(30.77%)和B/C混合型(17.31%),无A、E、F型存在。与CHB组比较,重肝组B型检出率明显降低,而C型和B/C混合型检出率明显升高。C型重肝患者BCPT1762/A1764双突变率显著高于B型(P<0.05),而前C区A1896突变率在B、C型感染者中差异无统计学意义(P>0.05)。结论C型感染易引起较重肝损伤,而B/C型混合感染可能是导致重肝发生的重要原因之一。C型重肝患者BCPT1762/A1764双突变率显著高于B型。Objective To investigate the relationship between hepatitis B virus genotypes and basic core promoter （BCP）/precore mutations in patients with severe hepatitis.Methods HBV genotypes were determined by polymerase chain reaction-restriction fragment length polymorphism （PCR-RFLP） in 52 patients with severe hepatitis and 52 cases with chronic hepatitis B （CHB）. Eight samples of genotypes B and C were randomly selected and their S gene was directly sequenced, and then their phylogenetic trees were analyzed. Fifteen samples of each of genotypes B and C were randomly selected and their BCP and precore genes were directly sequenced with PCR, and then the relationship between genotypes and BCP（T1762/A1764）/precore （A1896）mutations were analyzed. Results Genotype B,C and mixed genotypes （B and C） were detected in patients with severe hepatitis in Quanzhou area. Genotype B was the majority with a proportion 48.08% ,others had a proportion 30.77% and 17.31% ,respectively. Genotype A, E and F were not detected. The percents of genotype C, mixed B and C in severe hepatitis were significantly higher than that in CHB. The double mutation in BCP （T1762/A1764） was significantly more frequent in severe hepatitis with genotype C than that in genotype B （P 〈 0.05）. However, there was no significant difference in the distribution of precore mutant with A1896 between genotype B and C patients （P 〉 0.05）. Conclusions Genotype C may induce more severe liver inflammation than that genotype B may do. Mixed genotypes B and C infection may be an important determinant of inducing severe hepatitis. The double mutation in BCP （T1762/A1764） was more common in severe hepatitis with genotype C than that with genotype B.

关 键 词：肝炎病毒 乙型 基因型 聚合酶链反应 多态性 限制性片段长度 启动区(遗传学) 突变 

分 类 号：R512.6[医药卫生—内科学]