乙型肝炎病毒前C区A1896基因突变的检测方法及临床意义  

Detection of A1896 dot mutation located in hepatitis B virus pre C and clinical significance

作　　者：刘铁梅[1] 王涵[2] 李梓萌[3] 

机构地区：[1]吉林大学中日联谊医院输血科,吉林长春130033 [2]长春中医药大学附属第一医院检验科,吉林长春130000 [3]吉林大学白求恩医学院08级,吉林长春130000

出　　处：《中华医院感染学杂志》2011年第10期1971-1974,共4页Chinese Journal of Nosocomiology

基　　金：吉林省科技厅(201015186)

摘　　要：目的探讨乙型肝炎病毒（HBV）前C区A1896基因突变的检测方法及临床意义。方法通过荧光PCR熔解曲线分析,对乙型肝炎病毒脱氧核糖核酸（HBV-DNA）载量呈高滴度的HBeAg阴性的慢性乙型肝炎患者,做前C区A1896基因位点变异的检测,并对其临床用药治疗进行跟踪随访。结果在230例HBeAg阴性的慢性乙型肝炎患者中仍存在病毒复制的有168例,占总例数的44.2%;在168例HBeAg阴性的慢性乙型肝炎血清中有78例发生A1896位点变异,变异率达46.4%,其中接受恩替卡韦单药治疗12~16周时的好转率达45.0%,阿德福韦酯好转率40.0%,拉米夫定为16.0%。结论 3种核苷类似物单药治疗HBeAg阴性的慢性乙型肝炎患者A1896位点变异组12~16周时,恩替卡韦疗效优于拉米夫定和阿德福韦酯。OBJECTIVE To discuss the test methods and the clinical significance of 1896 dot mutation located in hepatitis B virus pre C.METHODS The A1896 dot mutation located in hepatitis B virus pre C of chronic hepatitis B patients whose HBV-DNA capacity presents high titer and HBeAg taken on negative were detected by fluorescence PCR experimen curve analysis and follow up the clinical therapy.RESULTS There were still 168 cases that have viral replication in 230 negative HBeAg chronic HBV cases,accounting for 44.2%;In the 168 cases,there were 78 cases presented mutation of 1896 dot,accounting for 46.4%.Among these cases the negative rates of ETV therapy in 12-16 weeks accounted for 45.0%,ADV accounted for 40.0%,LAM account for 16.0%.CONCLUSION Therapy of ETV is the best in three nucleoside analogues single-agent mentioned above for 1896 dot mutation chronic hepatitis B patients in 12-16 weeks.

关 键 词：慢性乙型肝炎 乙肝病毒脱氧核糖核酸 A1896基因突变 核苷类似物 

分 类 号：R512.62[医药卫生—内科学]