HBV逆转录酶区M204位点单独突变患者与M204+A181T联合突变患者临床特征的比较  

Comparisons of clinical characteristics between patients with M204 site and with M204/ A181T mutation in HBV reverse transcriptase region

作　　者：王春亚[1] 钟彦伟[2] 刘杰[1] 杨昊臻[3] 刘斌[4] 

机构地区：[1]解放军总医院急诊科,北京市100853 [2]解放军第302医院病毒性肝炎研究室 [3]解放军第302医院肝衰竭治疗中心 [4]解放军总医院消化内科,北京市100853

出　　处：《实用肝脏病杂志》2010年第4期260-262,共3页Journal of Practical Hepatology

摘　　要：目的了解HBV逆转录酶区M204位点单独突变患者与逆转录酶区M204+A181T联合突变患者临床特征的异同。方法对发生HBV逆转录酶区M204位点单独突变与逆转录酶区M204+A181T联合突变的慢性乙型肝炎患者血清HBsAg、HBVDNA和ALT水平进行统计学分析,并对所有患者的核苷(酸)类药物治疗史进行回顾性调查。结果逆转录酶区M204位点单独突变与逆转录酶区M204+A181T联合突变患者比,后者不会造成HBsAg和HBVDNA水平的下降(P值分别为0.3020和0.5917),也不会引起ALT(P=0.8001)的升高。此外,在核苷(酸)类药物应用方面,前者中单用拉米夫定的比例最高(41.38%),后者中由拉米夫定换用阿德福韦的比例最高(34.15%)。结论 rtM204位点单独突变与rtM204+rtA181T突变患者引起突变的核苷(酸)类药物使用情况有所不同,但两组病毒学指标的水平无明显的差异。Objective To explore the clinical characteristics between patients with M204 and with M204/ A181T mutation in HBV reverse transcriptase （rt）region. Methods Eighty-seven patients with rtM204 site mutation and forty-one patients with rtM204/rtA181T mutation were selected. The levels of HBsAg,HBV DNA and ALT were analyzed with statistic method. All the treatment history with nucleos（t）ide analogues（NA）were reviewed retrospectively. Results Compared to rtM204 site mutation, rtM204＋rtA181T mutation did not lead to the decline of HBsAg （P=0.3020）and HBV DNA （P=0.5917）and higher ALT level （P=0.8001）;Moreover,the mono-therapy of lamivudine was easy to induce rtM204 site mutation （41.38%）,while lamivudine swicthing to adefovir was easy to induce the rtM204＋rtA181T mutation （34.15%）. Conclusion The NAs for patients with rtM204 site mutation and for patients with rtM204＋rtA181T mutation were not the same,but the virological characteristics between them were not significantly different.

关 键 词：慢性乙型肝炎 乙型肝炎病毒 P基因 变异 

分 类 号：R512.62[医药卫生—内科学]