乙型肝炎病毒YMDD变异后果及原因分析  

The consequence and causes analysis of YMDD mutations in the hepatitis B virus DNA polymerase

作　　者：周一鸣[1] 曹建彪[1] 闻炜[1] 周小平[2] 焦建中[2] 

机构地区：[1]北京军区总医院肝病中心,北京100700 [2]解放军第一医院传染科

出　　处：《胃肠病学和肝病学杂志》2011年第11期1035-1037,共3页Chinese Journal of Gastroenterology and Hepatology

摘　　要：目的分析乙型肝炎病毒YMDD变异的原因及后果,探讨YMDD变异后应采取的措施,为变异后临床治疗提供依据。方法对乙型肝炎病毒YMDD变异的79例患者变异前后的临床及实验室资料进行回顾性分析。结果在拉米夫定抗病毒治疗者YMDD变异中,YVDD较YIDD变异多见;无拉米夫定治疗史者与有拉米夫定治疗史者YMDD变异后拉米夫定抗病毒治疗结果有显著性差异;YMDD变异前后肝功能损害有显著性差异;YVDD变异和YIDD变异比较,肝功能损害无显著性差异。结论未使用拉米夫定抗病毒者出现YMDD变异后,拉米夫定治疗有效;拉米夫定抗病毒治疗者,YMDD变异后患者肝功能损害明显;肝功能损害与YMDD变异的亚型无关。Objective To analyze the causes of YMDD mutation of hepatitis B virus DNA polymerase, and provide potential evidence for clinical treatment. Methods The retrospective analysis was used to evaluate clinical and labora- tory information of 79 hepatitis B patients with YMDD mutation. Results Our results indicated that YVDD mutation was more than YIDD in the hepatitis B patients with lamivudine treatment. For those patients with YMDD mutation, who ac- cepted anti-virus treatment or not, there was no statistical difference for the effect of lamivudine treatment. There was no difference of the damage degree of liver function between YVDD and YIDD mutation patients. YMDD mutation was closely related with the liver function in lamivudine treatment patients. Conclusion Lamivudine treatment is effective for patients with YMDD mutation which is not induced by lamivudine. YMDD mutation increases the damage of liver function. There is no difference for liver function between YVDD and YIDD mutation patients.

关 键 词：拉米夫定 YMDD变异 

分 类 号：R512.62[医药卫生—内科学]