乙型肝炎病毒C基因启动子区及前C区突变与乙型肝炎病情的关系  

The relationship between the progression of chronic Hepatitis B and the gene mutations in the regions of basic cone promoter and the pre-core

作　　者：宋红波[1] 武俊香[1] 贾因棠[1] 

机构地区：[1]山西医科大学第一医院,030001

出　　处：《山西医药杂志（上半月）》2009年第6期497-499,共3页Shanxi Medical Journal

基　　金：山西省出国留学回国人员基金项目(200156)

摘　　要：目的分析乙型肝炎病毒（HBV）C基因启动子（BCP）双突变及前C区nt1896位点突变与乙型肝炎临床表现及e抗原（HBeAg）表型的关系。方法采用巢式聚合酶链反应（PCR）扩增nt1660-1935的HBVDNA片段及PCR产物直接测序的方法检测BCP区及前C区基因的变异情况。结果130例经证实为HBVDNA阳性的急慢性肝炎患者中共有75例BCP区nt1762、nt1764双突变，HBeAg阳性组BCP突变者32例（58．2％），而HBeAg阴性组43例（57．3％）。检出前C区nt1896突变者20例，其中慢性肝炎10例（12．8％）、重型肝炎2例（25．0％）、肝硬化8例（22．2％）；nt1896突变者在HBeAg阳性组3例（5．5％），HBeAg阴性组17例（22．7％），两组比较差异有统计学意义。nt1896突变组丙氨酸转氨酶（ALT）及HBVDNA水平较无突变组差异均有统计学意义。结论BCP双突变及前Cnt1896均与肝炎的慢性化、重型化及肝硬化的发生密切相关，前者对HBeAg的表达及HBV-DNA水平并无明显影响；后者影响HBeAg的表达，并且增强病毒复制水平。Objective To investigate the gene mutations in the regions of basic core promoter （BCP） and pre core/core （Pre C/C） of HBV DNA and its clinical significance. Methods The nt1660- 1935 segment of HBV-DNA was amplified with nest PCR in 130 cases with hepatitis B. Then the PCR products were sequenced. Results Seventy-five cases of nt1762/1764 double mutations were detected in 130 patients with hepatitis B. Thirty-two cases （58.2%） and 43 cases （57.3%） of BCP double mutation were detected in the HBeAg positive group and HBeAg negative group respectively. Twenty cases of Pre-C nt1896 mutation composed of CH 10 cases （12.8%）, SH 2 cases （25.0%） and LC 8 cases （22.2%） were detected in 130 cases. Three cases （5.5%） and 17 cases （22.7%） Pre-C nt1896 mutations were detected in the HBeAg positive group and HBeAg negative roup respectively. The levels of ALT and HBV DNA in the Pre-C mutation group were higher than those in the wild type group. Conclusion BCP nt1762/1764 double mutation and the Pre-C nt1896 mutation are both closely related to the progression of chronic liver disease, nt 1762/1764 double mutation did not affect the expression of HBeAg and the ALT level whereas the Pre-C nt1896 mutation did.

关 键 词：肝炎病毒 乙型 启动区(遗传学) 突变 

分 类 号：R512.62[医药卫生—内科学] R512.6[医药卫生—临床医学]