广西桂北地区慢性HBV感染不同免疫状态与HBV基因型关系研究  

A study on relationship between different immune states of hepatitis B virus chronic infection and genotypes of hepatitis B virus in northern Guangxi

作　　者：吴淋玲[1] 杨丽莎[2] 蒋冬香[3] 王继业[4] 黄亚琴[1] 

机构地区：[1]桂林医学院附属医院消化内科,广西桂林541001 [2]桂林医学院附属医院中西医结合科,广西桂林541001 [3]桂林医学院附属医院检验科,广西桂林541001 [4]桂林医学院附属医院传染教研室,广西桂林541001

出　　处：《重庆医学》2011年第13期1249-1251,共3页Chongqing medicine

基　　金：国家自然科学基金资助项目(30760294);广西壮族自治区卫生厅重点科研课题[重200978]

摘　　要：目的了解广西桂北地区乙型肝炎病毒(HBV)基因型分布情况及探讨慢性HBV感染不同免疫状态与基因型的关系。方法将120例慢性HBV感染者按其免疫应答情况分为免疫耐受、免疫清除(应答)和免疫不全(病毒残留)3种免疫状态,各状态40例,运用实时荧光定量PCR法检测其HBV基因型。结果 B型86例,C型24例,B+C混合型6例,非B非C型4例;3种免疫状态均B型占多数,分别为70%、77.5%、67.5%,不同免疫状态基因型构成比差异无统计学意义(P>0.05);免疫状态与基因型相关性无统计学意义(P>0.05);B型HBV-DNA载量高于C型(P<0.05),大于或等于30岁组C型显著多于小于30岁组,差异有统计学意义(P<0.05);各基因型间ALT、AST、TBil、HBeAg阳性率差异无统计学意义(P>0.05);男女基因型分布差异无统计学意义(P>0.05)。结论广西桂北地区HBV基因型以B型为主,C型占部分比例,少量B+C混合型,偶有未能分型;还不能认为慢性HBV感染不同免疫状态间基因型分布不同及免疫状态与基因型相关。Objective To study the hepatitis B virus（HBV）genotypes distribution and to investigate the the relationship between the different immune states of HBV chronic infection and the genotypes of HBV in northern Guangxi.Methods The patients of HBV chronic infection were divided into three groups,immune tolerance,immune clearance and immunodeficiency,40 cases in each group.Using the real-time PCR to detected HBV genotypes.Results There were genotype B in 86 cases,genotype C in 24 cases,B＋C mixed genotype in 6 cases,nor B nor C genotype in 4 cases.Genotype B was mainly in the three different immune states,at 70%,77.5% and 67.5%.No significant difference was found in genotypes distribution of three different immune states and the relationship between immune states and genotypes（P0.05）.The level of HBV-DNA in genotype B was higher than that of genotype C（P0.05）.Genotype distribution showed no significant difference between different genders（P0.05）,but showed significant difference between different ages（P0.05）.The proportion of genotype C in the patients of ≥30 years old was higher than that in the patients of 30 years old（P0.05）.The level of ALT,AST,TBil and HBeAg（＋） had no significant difference（P0.05）.Conclusion The HBV genotypes distribution in northern Guangxi is major genotype B,partial genotype C,a little B＋C mixed genotype and little nor B nor C genotype.It is not sure that genotypes distribution is different in three different immune states and immune states is related with genotypes.

关 键 词：肝炎 乙型 慢性 免疫耐受 免疫清除状态 免疫不全状态 乙型肝炎病毒基因型 

分 类 号：R512.62[医药卫生—内科学]