徐州地区乙型肝炎病毒基因型与肝组织学改变的关系  

A study on the relationship between hepatic histological alterations and hepatitis B virus genotype in Xuzhou district

作　　者：王春颖[1] 杨友国[1] 王骥[1] 刘成永[1] 王海舰[1] 周冬青[1] 侯远沛 

机构地区：[1]徐州市传染病医院,221004

出　　处：《江苏医药》2008年第2期139-141,共3页Jiangsu Medical Journal

基　　金：2005年徐州市市级科研课题(X2005-23104)

摘　　要：目的研究徐州地区HBV基因型与肝组织学改变的关系。方法采用DNA测序技术进行HBV基因分型,并结合其ALT、TBil、HBeAg和HBV DNA定量值及肝组织病理学检查结果,分析HBV基因型与肝损害的关系。结果检测222例慢性乙型肝炎(CHB)患者,徐州地区HBV基因型构成为B、C、BC混合型和D型分别占20.7%、73.0%、4.1%和2.3%。在CHB患者中B、C基因型在性别、年龄、肝功能和HBeAg的定量值及百分率均无显著差异(P>0.05),C型的HBV DNA定量值显著高于B型(P<0.05);C型基本核心启动子区(BCP)1762、1764变异率显著高于B型,P<0.01;C型的肝组织炎症评分和纤维化评分明显高于B型(P<0.05);B和C基因型中,单独1762、1764双突变者与无此类位点变异者和单独前C区1896变异者炎症评分相比较前者显著高于后两者(P<0.05)。结论不同HBV基因型变异位点不同,可能是造成不同的肝组织学改变的原因之一,C型可带来相对严重的肝组织学改变。HBV基因型及肝组织学检查有助于判断疾病的轻重及预后,可用于临床指导治疗。Objective To study the relationship between hepatic histological alterations and hepatitis B virus genotype in Xuzhou district. Methods HBV genotype was detected by DNA sequencing technique. The relationship was investigated between liver damage and hepatitis B virus genotype by analyzing ALT, TBIL, the quantitation of HBV DNA and HBeAg, and the results of hepatic histological alterations. Results The genotypes in Xuzhou district were B （20. 7%）, C （73.0%） ,mixed BC（4.1%）and D（2.3%）. There was no significant difference between B and C genotypes compared the results of sex, age, liver function and the quantitation of HBeAg with chronic hepatitis B patients（P〉0. 05）. The quantitation of HBV DNA in genotype C was higher than that in genotype B（P〈0.05）. The mutation rate of BCP1762/1764 in genotype C was higher than that in genotype B, （P〈0. 01）. The liver tissue inflammation grade and liver fibrosis grade in genotype C were significantly higher than those in genotype B, （P〈0.05）. The liver tissue inflammation grade of only double-mutation in BCP（T1762/A1764） was significantly higher than that of only pre-C（1896） mutation and no such sites mutations in genotype B and C（P〈0. 05）. Conclusions Different HBV genotype leads to different mutation rate of important sites and brought different hepatic histological alterations. Genotype C can cause more severe hepatic histological alterations. The detection of HBV genotype and hepatic histopathologic changes benefits predicting the diagnosis of the disease and directing the therapy.

关 键 词：乙型肝炎病毒 基因型 肝组织学 变异 

分 类 号：R512[医药卫生—内科学]