32例慢性乙型肝炎患者HBV P区的多位点耐药突变分析  

Analysis of drug-resistant multi-loci mutaion of P area of HBV genome in 32 patients with chronic hepatitis B

作　　者：叶非[1] 李晓鸥[2] 过建春[2] 武静[2] 

机构地区：[1]浙江大学医学院,杭州310008 [2]杭州市第六人民医院

出　　处：《中华实验和临床病毒学杂志》2011年第3期208-210,共3页Chinese Journal of Experimental and Clinical Virology

摘　　要：目的 深入了解核苷（酸）类似物对乙型肝炎病毒基因组P区耐药性突变的影响,分析其对该区诱导耐药突变的作用.方法 对服用核苷（酸）类似物并且发生病毒学突破的患者,采用PCR产物直接测序法,进行HBV基因组P区耐药性基因测序分析.结果 发现P区可出现多点耐药突变,导致临床上发生交叉耐药和多重耐药.结论 应选用高耐药基因屏障的药物进行初始抗病毒治疗.对长期服用核苷（酸）类似物的患者,应定期监测HBV DNA,以便早期发现病毒学突破并及时干预.Objective In order to deeply understand the effects of nucleoside analogues to HBV DNA polymerase area, which initiate a state of drug resistance due to HBV genome mutation. Methods Using PCR product direct sequencing method to test the gene sequence of P area of HBV genome of the patients who taking nucleoside analogues and showing signs of virologic breakthrough. Results More resistance mutations can be find in HBV DNA polymerase area,which causing clinically cross drug resistance and multiple resistance. Conclusion We should choose higher genetic barrier for the initial treatment. And the patients long-term using of nucleoside analogues, should be regularly monitored serum HBV DNA level, in order for early detection of virological breakthrough and timely intervention.

关 键 词：肝炎病毒 乙型 药物耐受性 突变 

分 类 号：R512.62[医药卫生—内科学]