乙型肝炎病毒e抗原阴性慢性乙型肝炎与前C基因及C基因变异关联性临床研究  

Clinical investigation of association of mutations in the core promoter and precore region of HBeAg negative chronic hepatitis B

作　　者：孙晓红[1] 李淑琴[2] 武宇州[3] 刘涛[1] 张旖晴[1] 张岳[1] 魏玮[1] 

机构地区：[1]中国中医科学院望京医院脾胃病科,北京100102 [2]河北医科大学基础医学院病理生理教研室,河北石家庄050011 [3]河北医科大学第二医院心血管内科,河北石家庄050071

出　　处：《河北中医》2011年第9期1424-1425,共2页Hebei Journal of Traditional Chinese Medicine

摘　　要：目的临床观察乙型肝炎病毒e抗原(HBeAg)阴性的慢性乙型肝炎(e-CHB)与前C基因及C基因变异的关联性。方法将慢性乙型肝炎193例进行血清HBeAg、乙型肝炎病毒脱氧核糖核酸(HBV-DNA)水平、前C基因核苷酸1896G→A点突变及C基因核苷酸1762碱基A→T和1764G→A联合突变的检测。结果慢性乙型肝炎193例中,①HBeAg阴性70例(36.27%),HBeAg阳性123名(63.73%)。②HBeAg阴性前C基因变异率76%,HBeAg阳性前C基因变异率31%,二者比较差异有统计学意义(P<0.05);HBeAg阴性C基因变异率51%,HBeAg阳性C基因变异率30%,二者比较差异无统计学意义(P>0.05)。③HBeAg阳性患者中,前C基因或C基因变异群的HBV-DNA水平低于未变异群,差异比较有统计学意义(P<0.05),而HBeAg阴性患者中,前C基因或C基因变异群与非变异群比较,血清HBV-DNA水平差异比较均无统计学意义(P>0.05)。结论在e-CHB中,前C基因变异与HBeAg转阴具有密切关系,而C基因变异与HBeAg转阴关系不明确;前C基因和C基因变异不能增强病毒毒性,与疾病严重程度可能无关。Objective To investigate the association of mutations in the core promoter and precore region of HBeAg negative chronic hepatitis B.Methods Serum HBeAg,HBC-DNA,mutations in the core promoter and precore region in 193 patients with chronic hepatitis B were detected using enzyme-linked mini-sequence assay kit and HBV core promoter mutation detection kit Results There were 123（63.73%） HBeAg-positive and 70（36.27%） HBeAg-negative patients.HBeAg-negative patients had significantly lower HBV DNA levels compared with the HBeAg-positive patients（mean 5.0 to 8.3 Log copies/mL,P0.05）.The precore mutation rate was significant higher in HBeAg-negative patients than that in HBeAg-positive patients（76% to 30%,P0.05） but there was no significant difference on the core promoter mutation rate between HBeAg-negative and positive patients（51% to 30%,P0.05）.In HBeAg-negative group,patients with precore or core promoter mutations had a lower serum HBV DNA level compared with that in the patients with wild type（P0.05） but in HBeAg-positive group there was no significant difference between the patients with mutation type and wild type（P0.05）.Conclusion Precore mutation may be associated with HBeAg seroconversion but core promoter mutation is not associated with it.The precore mutation and core promoter mutation cannot enhance virulence,and maybe not related to disease severity.

关 键 词：肝炎 乙型 慢性 肝炎e抗原 乙型 基因 病毒 

分 类 号：R373[医药卫生—病原生物学] R373.21[医药卫生—基础医学]