乙型肝炎病毒Bcp／pc区变异位点与拉米夫定治疗关系  

Clinical Observation on the Relationship Between Mutations of Hepatitis B Virus Bcp/pc Area and Lamivudine Treatment

作　　者：曹春蕊[1] 郄兰霞[1] 黄艳[1] 戴二黑[1] 李新华[2] 

机构地区：[1]河北省石家庄市第五医院感染四科,河北石家庄050051 [2]河北省玉田县医院感染疾病科,河北玉田064100

出　　处：《医学临床研究》2013年第9期1690-1692,共3页Journal of Clinical Research

摘　　要：【目的】探讨乙型肝炎病毒（HBV）Bcp／pc区变异位点与拉米夫定抗病毒治疗后HBVDNA反弹的关系。【方法】检测41例拉米夫定治疗（100mg／d）1年以上，达到病毒学应答半年以上，再出现HBVDNA反弹的乙型肝炎患者（反弹组），以及36例拉米夫定治疗HBVDNA持续阴性患者（对照组）的Bcp／pc区突变住点。【结果】反弹组治疗后BCPT1762／A1764双突变检出率（75．6％）高于治疗前检出率（48．8％，P=0．023），同时也高于对照组检出率（39．0％，P=0．010）。反弹组41例中YMDD变异检出率为63．4％（26／41）。经多因素回归分析发现，YMDD变异（OR=55．323，P〈O．001）、BCPTl762／A1764双突变（OR=10．851，P=0．013）是HBVDNA反弹的独立预测因素，而前C区A1896突变与HBVDNA反弹无明显关联。【结论 BCPA1762T／G1764A双突变可能与拉米夫定治疗后HBVDNA反弹有关。[Objective] To explore the relationship between the mutations of hepatitis B virus（HBV） Bcp/pc area and HBVDNA rebound after lamivudine antiviral therapy. [Methods] Mutations of HBV Bcp/pc area of 41 hepatitis B patients with HBVDNA rebound after 100mg/d lamivudine therapy for more than one year and virology response for more than half a year（rebound group） and 36 patients with continuous negative HBVDNA（control group） were detected. [Results] The detection rate of dual mutations of BCP T1762/A1764 in rebound group （75.6 %） after treatment was higher than that before treatment（48.8 %）（ P = 0. 023）, and also higher than that in control group（39.0% ）（ P = 0. 010）. The detection rate of YMDD mutation in 41 patients of rebound group was 63.4%（26/41）. Multivariate regression analysis showed that YMDD mutation（OR= 55. 323, P d0. 001） and BCPT1762/A1764 double mutations（OR= 10. 851, P = 0. 013） were independent predictive factors of HBVDNA rebound, while A1896 mutation in pre-C area had no obvious correlation with HBVDNA rebound. [Conclusion] BCPA1762T/G1764A double mutants may be associated with HBVDNA rebound after lamivudine treatment.

关 键 词：肝炎病毒 乙型 拉米夫定 治疗应用 

分 类 号：R373.21[医药卫生—病原生物学]