阿德福韦酯治疗慢性乙型肝炎产生耐药变异与病毒载量的关系  

Relationship between drug resistant mutant caused by adefovir dipivoxil in treating chronic hepatitis B and serum virus levels

作　　者：谢欣城[1] 张永乐[2] 张思泉[1] 武静[2] 

机构地区：[1]杭州市第六人民医院消化内科,浙江杭州310014 [2]杭州市第六人民医院分子诊断实验室,浙江杭州310014

出　　处：《中华医院感染学杂志》2011年第8期1517-1519,共3页Chinese Journal of Nosocomiology

基　　金：浙江省自然科学基金(y2091061;y2101367)

摘　　要：目的观察阿德福韦酯治疗慢性乙型肝炎(CHB)发生病毒变异与血清病毒载量的关系。方法采用平行配对法,选择45例经阿德福韦酯治疗发生变异(变异组)和45例经阿德福韦酯治疗96周未发生变异(未变异组),分析治疗前变异组和未变异组血清HBV-DNA定量水平;分析变异组中不同变异位点在变异后血清HBV-DNA定量水平。结果变异组治疗前血清HBV-DNA定量平均对数值为(7.26±1.22)IU/ml较未变异组平均对数值(6.20±1.28)IU/ml明显增高,差异有统计学意义(P<0.01);变异组中存在rtA181T/V位点,rtN236T位点及二者联合变异3种情况所占变异比例为66.67%、15.56%、17.77%,发生rtN236T位点变异时变异后血清HBV-DNA含量要较发生rtA181T/V位点变异后HBV-DNA含量高,差异有统计学意义(P<0.01)。结论 CHB患者血清HBV-DNA病毒载量越高,应用阿德福韦酯治疗越容易发生变异;发生rtN236T位点变异后HBV-DNA反弹幅度较发生rtA181T/V位点变异后HBV-DNA反弹幅度高。OBJECTIVE To observe the relationship between serum virus levels and mutant resistant about adefovir dipivoxil in the treatment of chronic hepatitis B（CHB）.METHODS A total of 45 cases with variation and 45 patients without variation on 96 weekend who were treated with adefovir dipivoxil and were divided into variation group and no variation group respectively by parallel matching method.Serum HBV DNA ration levels of the two groups were measured before the treatment.RESULTS Before the treatment,the average of the values of serum HBV DNA ration levels in the variation group was（7.26±1.22）IU/ml,which was higher than（6.20±1.28）IU/ml in the group without variation（P0.01）.The variations of rtA181T/V site,rtN236T site and rtA181T/V ＋ rtN236T site were observed in the variation group,the ratios were 66.67%,15.56% and 17.77%,respectively.The serum HBV DNA levels in the rtN236T site variation group were higher than that in the rtA181T/V site variation group（P0.01）.CONCLUSIONS The higher the serum HBV DNA load is the easier the viral variation will be in CHB patients treated by adefovir dipivoxil.HBV DNA bounce range is wider in the rtN236T site variation group than that in the rtA181T/V site variation group.

关 键 词：慢性乙型肝炎 阿德福韦酯 病毒 变异 

分 类 号：R512.62[医药卫生—内科学]