承德地区HBV基因型与拉米夫定疗效及耐药变异研究  

Influence of HBV genotypes on therapeutic effect of lamivudine and HBV drug resistance mutation in Chengde

作　　者：胡玉弘[1] 陈玲玲[1] 李莹[1] 刘文博[1] 冯军[1] 

机构地区：[1]承德市中心医院检验科,河北承德067000

出　　处：《中国卫生检验杂志》2014年第1期138-139,141,共3页Chinese Journal of Health Laboratory Technology

摘　　要：目的研究承德地区HBV基因型与拉米夫定疗效及耐药变异关系。方法 58例入选慢性乙肝病人接受拉米夫定抗乙肝病毒治疗48周。比较治疗48周后HBV-DNA载量变化、ALT复常率、HBeAg血清转换率及耐药变异情况。采用FQ-PCR法进行HBV-DNA定量检测及HBV基因分型和YMDD变异检测。结果拉米夫定治疗48周后,大部分患者HBV-DNA载量、ALT复常率及HBeAg血清转换率较基线改善,且B、C两基因型间差异无统计学意义。在17例HBV-DNA反弹的患者中,16例检出YMDD变异,其中C型12例,B型4例。结论拉米夫定能明显抑制HBV复制,促进ALT复常和HBeAg血清转换。拉米夫定抑制HBV疗效与HBV基因型B型或C型无关。YMDD变异率在B、C基因型病人中无差别,但变异后基因型C病毒复制水平比基因型B要高。Objective To study the relationship between hepatitis B virus （HBV） genotypes and drug resistance mutation, as well as therapeutic effect of lamivudine in Chengde area. Methods Antiviral treatment with lamivudine was conducted on 58 hepatitis B patients for 48 weeks. The HBV - DNA load, ALT normalization, HBeAg seroconversion rate and drug resistance mutation in these 58 patients were compared before and after lamivudine treatment. FQ - PCR was used to detect HBV - DNA load, HBV genotyping and YMDD mutation. Results After lamivudine treatment, the HBV - DNA load, ALT normalization and HBeAg seroconversion rate were significantly improved in most HBV patients, and there was no difference between genotype B and C. Sixteen patients were found YMI）D mutation in the 17 HBV - DNA rebound patients, including 12 cases with genotype C and 4 cases with genotype B. Conclusion Lamivudine can obviously inhibit HBV replication, promote ALT normalization and HBeAg seroconcersion, and the lamivudine inhibition on HBV curative effect has no relation to genope B and C. YMDD mutation has no difference between genotype B and genotype C of hepatitis B patients, but genotype C showed higher virus replication level than that of genotype B after YMDD mutation.

关 键 词：乙型肝炎 拉米夫定 基因型 YMDD变异 

分 类 号：R512.62[医药卫生—内科学]