应用型特异性引物巢式PCR分析温州地区乙型肝炎病毒基因型及其临床意义  

Study on hepatitis B virus genotypes in Wenzhou district by PCR using type-specific primers and its clinical significance

作　　者：曹家麟[1] 吴春明[1] 朱小区[1] 欧阳钦[1] 苏林红[1] 

机构地区：[1]浙江中医药大学附属温州中医院肝病科,温州325000

出　　处：《临床医学》2009年第4期88-91,共4页Clinical Medicine

基　　金：温州市医药卫生科学研究基金资助(2008065)

摘　　要：目的了解温州地区乙型肝炎病毒(HBV)基因型的分布及其与临床的相关性。方法选取温州地区HBVDNA阳性的慢性HBV感染者202例,其中慢性无症状乙型肝炎表面抗原携带者52例,慢性乙型肝炎103例,肝硬化27例,肝细胞癌20例,应用型特异性引物巢式PCR检测HBV的基因型。结果202例HBV DNA阳性血清标本中,B型37例(18.3%),C型123例(60.9%),B/C混合型41例(20.3%),D型1例(0.5%),未发现A、E、F和G型;与B基因型、B/C混合型相比,C基因型在慢性乙型肝炎和肝细胞癌中明显升高,分别为56.1%和14.6%(P(0.05);C基因型感染者血清丙氨酸氨基转移酶水平(226±268)U/L高于B基因型的(114±183)U/L和B/C混合型的(130±222)U/L,差异有统计学意义(P(0.05);C基因型感染者HBeAg阳性率和HBV DNA含量明显高于B基因型和BC混合型感染者相比,差异有统计学意义(P(0.05)。结论温州地区存在HBV的B、C、D和B/C混合基因型,C型为本地区的优势基因型,并且C型HBV感染易引起较重肝脏损伤。Objective To investigate the distribution of hepatitis genotypes in Wenzhou district detected by using type - specific primers PCR and its clinical significance. Methods Serum samples from 202 HBV DNA positive patients with chronic HBV infeefion, including 52 chronic asymptomatie carriers （ ASC ） , 103 ehronie hepatitis B （ CHB ） , 27 liver cirrhosis （ LC ） and 20 hepatocellular carcinoma （HCC） patients were collected and detected for HBV genotypes by type -specific primers PCR. Results Of all 202 patients, 37 eases （ 18.3% ） were genotype B, 123 eases （60.9%） were genotype C and 41 eases were mixtures of genotype B and C. Genotype C was more prevalent in the CHB and HCC than genotype B and mixtures of genotype B/C （ P 〈 0.05） ; the ALT value and HBV DNA was significantly higher in genotype C than that in genotype B, mixtures of genotype B/C patients （ P 〈 0.05 ）, The positive rate of HBeAg was also significantly higher in genotype C than in genotype B, mixtures of genotype B/C patients （ P 〈 0.05 ）. Conclusion Genotype B, genotype C, genotype D and BC combination exist in Wenzhou district, and genotype C is the major genotype in this area,which may induce more severe the liver inflammation.

关 键 词：肝炎病毒 乙型 基因型 多聚酶链反应 型特异性引物 

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