贵州省乙型肝炎病毒前C区及基本核心启动子变异分布  

Study on the distribution of hepatitis B virus precore and basic core promoter mutations in Guizhou area

作　　者：丁静娟[1] 刘悦晖[1] 王梅[1] 

机构地区：[1]贵阳医学院附属医院感染科,550004

出　　处：《中华流行病学杂志》2007年第2期169-172,共4页Chinese Journal of Epidemiology

基　　金：基金项目：国家自然科学基金资助项目（30360098）;贵州省优秀科技教育人才省长基金资助项目.

摘　　要：目的调查贵州省乙型肝炎病毒（HBV）前C区A1896、基本核心启动子区（BCP）T1762／A1764变异分布。方法收集贵阳、遵义、凯里、都匀4地区不同民族无症状携带者（AS（2）、慢性肝炎（CH）、肝炎肝硬化（LC）、肝细胞肝癌（HCC）患者血清482份，用测序及限制性片段长度多态性检测A1896、T1762／A1764变异。用S基因PCRRFLP确定基因型。结果A1896、T1762／A1764变异检出率分别为23．03％和29．67％。汉族感染者A1896、T1762／A1764变异检出率为27．64％和36．04％，高于侗、苗、布依族感染者合并后的7．96％、8．85％（P〈0．01）。A1896变异在B、C基因型中的分布为20．34％和27．13％（P〉0．05），T1762／A1764变异为18．97％和46．28％（P〈0．01）。A1896、T1762／A1764变异在HBeAg阴、阳性组间的分布差异有统计学意义（P值均〈0．01）。从ASC到HCC组，A1896、T1762／A1764变异分布逐渐增高，LC、HCC组的检出率明显高于CH和ASC组（P值均〈0．01）。A1896、T1762／A1764变异的分布：贵阳（分别为31．79％和41．06％）高于遵义（10．94％和14．06％）、都匀（8．64％和11．11％）及凯里（2．86％和2．86％），但多因素logistic回归分析在控制了HBeAg、HBV基因型及临床类型影响后，在地区间分布差异无统计学意义。结论A1896、T1762／A1764变异在贵州省不同民族间分布有一定差异。C型感染者易发生T1762／A1764变异，两种变异均与疾病进展有关。Objective To investigate the distribution of hepatitis B vires （HBV） precore A1896 and basic core promoter（BCP）T1762/A1764 mutations in Guizhou area. Methods 482 patients with chronic HBV infection, belonging to 4 nationalities, including 225 asymptomatic carriers （ASC）, 158 chronic hepatitis（CH）, 57 liver cirrhosis （LC）, 42 hepatocellular carcinoma （HCC）, from 4 areas of Guizhou province were examined. HBV A1896 and T1762/A1764 mutations were determined by direct sequencing and restriction fragment length polymorphism（RFLP）. HBV genotypes were determined by PCR-RFLP based on S gene. The relationship among these mutations and genotype and the progression of liver disease were studied by multi-normal logistic regression analysis. Results A1896 and T1762/A1764 mutations were detected 23.03 % and 29.67% among 482 patients. These mutations were more prevalent in Hans than in Dong, Miao and Buyi minorities （P〈 0.01, respectively）. The mutations of A1896 and T1762/ A1764 were more commonly seen in HBeAg negative than in HBeAg positive patients （P〈 0.01, respectively）. The mutation of T1762/A1764 was significantly higher in genotype C than in genotype B （P〈 0.01 ）. There were significantly statistical differences in the detective rate of A1896 and T1762/ A1764 mutations between patients with HCC, LC and CH, ASC. The distribution of these mutations in Guiyang（31.79% and 41.06%） was higher than in Zunye（10.94%, 14.06%）,Duyun（8.64%, 11.11% ） or Kaili（2.86 % , 2.86 % ）. However, there was no statistical difference by multi-normal logistic regression analysis after controlling the influence of HBeAg statu, genotype and clinical types. Conclusion The distributions of A1896 and T1762/A1764 mutations were different in some nationalities of Guizhou province. The mutation of T1762/A1764 was more commonly seen in genotype C than in genotypr B. These mutations were closely related to progression of chronic liver diseases.

关 键 词：乙型肝炎病毒 变异 限制性片段长度多态性 

分 类 号：R686[医药卫生—骨科学]