重庆地区乙肝病毒基因型分布及其临床意义  

HBV genotype distribution and its influences on progression of HBV-related chronic liver disease in Chongqing population

作　　者：谭文婷[1] 邓国宏[1] 王宇明[1] 但芸婕[1] 况雪梅[1] 

机构地区：[1]第三军医大学西南医院全军感染病研究所,重庆400038

出　　处：《第三军医大学学报》2008年第24期2321-2323,共3页Journal of Third Military Medical University

基　　金：国家自然科学基金(30671850);教育部"新世纪优秀人才支持计划"(2007-0146)~~

摘　　要：目的调研重庆地区乙型肝炎病毒(hepatitis B virus, HBV)基因型构成,探讨HBV基因型与乙型肝炎疾病进程的相关性。方法用SSP-PCR法对360例HBV DNA阳性患者HBV基因分型,采用多因素Logistic回归分析HBV基因型与疾病表型的相关性。结果本回顾性研究人群中,HBV-B型占45.6%,HBV-C型占53.9%,分型失败0.5%。随着疾病从慢性乙型肝炎到肝硬化、原发性肝细胞癌的进展,C型HBV所占比例显著上升(χ2=23.368,P<0.001)。Logistic回归分析显示HBV基因型是HBV感染者罹患肝癌的独立风险因素(OR=3.2,P=0.01)。B、C基因型患者的HBV DNA水平和HBeAg阳性率无显著差异(P>0.05)。结论重庆地区HBV基因型以B、C型为主,C型HBV更易导致严重的肝病,HBV基因型是影响疾病进程的重要因素。Objective To study the distribution of hepatitis B virus （HBV） genotypes in Chongqing city and its clinical influences. Methods The genotype of HBV was detected by SSP-PCR while the HBV DNA by FQ-PCR and HBeAg by ELISA. Results Among 360 HBV DNA positive patients who have lived in Chongqing, the prevalence of HBV/B and C was 45.6% and 53.9% , respectively. The rate of genotype C increased with the progression of chronic liver disease from chronic hepatitis B （CHB） （42.4%）, liver cirrhosis （LC） （67.4%） to hepatocellular carcinoma （HCC） （74.0%）, with significant differences among these groups （χ^2 = 23. 368, P 〈0. O1 ）. Logistic regression analysis indicated that HBV genotype is an independent risk factor for HBV-related HCC （ OR = 3.2, P = 0. 01 ）. No significant difference was found in the positive rate of HBeAg or the serum level of HBV DNA among the patients of genotype B and C （P 〉 0. 05）, even though the positive rate of HBeAg was slightly higher in the patients of genotype B （40.9%） than that of genotype C （36.1%）. Conclusion Genotype C and B are the dominant genotypes for Chongqing population. The damage to liver induced by genotype C is more severe than that by genotype B. HBV genotype plays a role in the progression of serious HBV-related liver disease.

关 键 词：肝炎病毒 乙型 基因型 疾病表型 HBV DNA 

分 类 号：R181.33[医药卫生—流行病学] R373.21[医药卫生—公共卫生与预防医学]