重型肝炎血清HBV前C区A83变异株比率的动态观察  

The percentage of hepatitis B virus precore A83 mutant and its dynamic change in fulminant hepatitis B

作　　者：田琦琦[1] 郭素萍[1] 谭复明[1] 李明山[1] 李江[1] 王志明[1] 

机构地区：[1]解放军第260医院传染科,石家庄050041

出　　处：《中华肝脏病杂志》2000年第2期96-98,共3页Chinese Journal of Hepatology

摘　　要：目的了解ＨＢＶ前Ｃ区Ａ ８３变异与重型肝炎的关系。方法用套式错配ＰＣＲ限制片段长度多态性分析和凝胶光密度图象分析仪及定量 ＰＣＲ，对９例重型肝炎患者血清 ＨＢＶ变异株的比率和 ＨＢＶ ＤＮＡ含量进行测定和动态观察。结果Ａ８３变异株在６例阳性者中均与野生株呈混合感染，其比率＞５０．０％的仅２例，存活死亡各１例；＜３１．０％的４例均死亡。变异株的出现及其比率变化与ＨＢＶ ＤＮＡ含量的消长一致，但无统计学相关性（ｒ分别为０．６０和０．５８２ Ｐ值均＞０．０５）。结论该变异株单独引发重型肝炎的可能性极微，它在重型肝炎中的出现可能只是高度免疫压力下病毒复制过程中的伴随现象。Objective In order to clarify whether hepatitis B virus precore A83 mutant is related to the pathogen- esis of fulminant hepatitis B or not. Methods The percentage of hepatitis B virus precore A83 mutant and the quantity of HBV DNA in sera from 9 patients with fulminant hepatitis B were assayed by the method of densitometry after mispairing PCR-restriction fragment length polymorphism (mpPCR-RFLP) and quantitative PCR, respectively. Results The HBV precore A83 mutant was found in sera of 6 out of 9(66.7%) fulminant hepatitis patients while none of them were infected with the mutant strain alone, and all were mixed with wild strain. The percentage of the mutant over fifty percent is only in 2 cases in whom one was 59.3%(survival) and another 64.8%(died). The percentage below 31.0% was in 4 cases and all of them died. It was observed that appearance or disappearance of the A83 mutant and its dynamic change of percentage were consistent with the fluctuation of HBV DNA level but there was no correlation statistically(r = 0.602, 0.583; P > 0.05). Con- clusion The mutant strain alone has little correlation to the occurrence of fulminant hepatitis. It might be merely a accom- paniment to follow the replication of HBV under the highly immune pressure.

关 键 词：前C区 比率 重型肝炎 A83变异株 HBV-DNA 

分 类 号：R512.602[医药卫生—内科学]