中国西部、北部地区410例汉族病例乙型肝炎病毒基因型与肝病转归的相关性研究  

The relationship between the hepatitis B virus genotype and clinical outcomes in northern and western chinese population

作　　者：黄中红[1] 田国宝[1] 崔建军[1] 田地[1] 于敏[2] 席宏丽[2] 陆海英[2] 曾争[2] 

机构地区：[1]北京大学第一医院感染疾病科病毒研究室,100034 [2]北京大学第一医院感染疾病科,100034

出　　处：《北京医学》2008年第12期705-709,共5页Beijing Medical Journal

基　　金：国家自然科学基金资助项目(NO.30671855);美国国家癌症研究所(NCI)资助项目(N01-CO-12400)

摘　　要：目的探讨乙型肝炎病毒(hepatitis B virus,HBV)基因型与肝病转归的关系。方法随机选取中国西部、北部地区汉族HBV感染者DNA含量104以上者410例,煮沸法提取HBV基因组模板,PCR扩增S区基因,应用自动测序仪测定目的基因序列,进行基因分型,应用SPSS10.0软件统计分析。结果C型占91.95%,B型占6.83%,B、C混合型占0.24%,D型占0.98%。疾病进展研究分4种情形对基因型C、基因型B进行单因素方差分析:慢性病毒携带者(ASC),慢性乙型肝炎(chronic hepatitisB,CHB),肝硬化(liver cirrhosis,LC),原发性肝细胞性肝癌(primary hepatocellular carcinoma,HCC)。统计显示,感染基因型C后CHB更易发展为LC和(或)HCC,有统计学意义,但两基因型之间LC发展为HCC差别无统计学意义。LCvs.(CHB+HCC)统计显示:两组在基因型方面虽无统计学差异,但从Means Plots可以看出感染基因型C向肝硬化或肝细胞癌方向发展的趋势更明显。结论中国西部、北部汉族HBV感染者中以感染基因型C为主,且感染基因型C较基因型B更容易发展为严重的肝病。Objective To discuss the relationship between the HBV genotype and clinical outcomes. Methods 410 cases of northern and western chinese population with HBV persistent infection were enrolled, whose HBV DNA levels were more than 10^4 copies/ml. HBV genome DNA was extracted by boiling method. The S gene was amplified by PCR and sequenced by ABI 3730. Results Genotype C in 377 cases corresponded to 91.95%, genotype B in 28 cases corresponded to 6.83%, mixed genotype of C and B only in one case corresponded to 0.24%, genotype D in four cases corresponded to 0.98%. Disease progression for genotype C and genotype B was studied through One-way ANOVA for 2 statuses, which were CHB vs. LC vs. HCC and LC vs. （CHB＋HCC）. There was statistical significance between CHB and LC or HCC. But it had no statistical significance between LC and HCC. Conclusions The HBV genotype C is the predominate infection in north chinese population and the genotype C infection may develop into more severe condition than genotype B.

关 键 词：乙型肝炎病毒 基因型 转归 

分 类 号：R512.62[医药卫生—内科学] R450[医药卫生—临床医学]