乙型肝炎病毒相关性肾小球肾炎患者病毒X基因变异分析  

Mutation analysis of hepatitis B virus X gene in hepatitis B virus-associated glomerulonephritis

作　　者：董晖[1] 徐岩[1] 刘丽秋[1] 关广聚[2] 蒋伟[1] 

机构地区：[1]青岛大学附属医院肾病科,266003 [2]山东大学第二医院肾病科

出　　处：《中华肾脏病杂志》2014年第4期273-278,共6页Chinese Journal of Nephrology

基　　金：山东省高等学校科技计划项目（J11LF21）

摘　　要：目的探讨乙型肝炎病毒（HBV）x基因突变在HBV相关性肾小球肾炎（HBV—GN）发病中的意义。方法分别从50例HBV—GN患者及60例无症状乙肝病毒携带者（对照组）中采集静脉血，提取DNA测定HBVDNA含量并以聚合酶链反应技术对HBVDNA的x基因进行扩增，并对扩增产物进行测序。测定50例HBV．GN患者24h尿蛋白量。结果（1）HBV—GN组和对照组的年龄及男女比例差异无统计学意义（P〉0．05）；42例x基因变异HBV．GN患者与对照组间HBVDNA复制水平差异无统计学意义（P〉0．05）；42例伴有x基因变异HBV．GN患者24h尿蛋白量高于无x基因变异HBV—GN患者，差异有统计学意义（P〈0．05）。（2）HBV．GN组有42例发生了核苷酸序列点突变，并导致了氨基酸的替代，占总人数的84％，核苷酸序列错义突变主要发生于以下位点：nt1653、nt1726、nt1727、nt1730、nt1753、nt1762、nt1764，突变位点集中在X基因反式作用调控区。（3）对照组中有5例发生了核苷酸序列错义突变，仅占8％，分别是nt1632及nt1635，且突变均在非功能区域。结论大多数HBV-GN患者存在x基因一些关键位点的突变，并导致了氨基酸的替代，x基因突变HBV-GN患者尿蛋白量增加，提示这些关键位点的突变可能在HBV-GN的致病中起到重要作用。Objective To determine whether mutation of Hepatitis B virus （HBV） X gene is associated with hepatitis B virus associated glomerulonephritis （HBV- GN）. Methods The venous blood was collected from 50 patients with HBV- GN and 60 patients with asymptomatic HBV carriers （control group）. Serum HBV DNA was extracted to determine the serum titer of HBV-DNA and then polymerase chain reaction （PCR） was used to detect the HBV X gene mutation. Results （1）There were not statistical significance between age and gender in HBV- GN group and control group （P 〉 0.05）. There were not statistical significance of serum replication level of HBV DNA in HBV-GN with X gene mutation and control group （P 〉 0.05）. Urine protein excretion in HBV- GN group with or without X gene mutation was found with statistical significance （P 〈 0.05）. （2）Nucleotide mutations [84% （42/50）] resulted in amino acid substitution in HBV- GN. Nucleotide mutations changed in trans function control region of X gene, including position nt1653, nt1726, nt1727, nt1730, nt1753, nt1762 and nt1764. （3）Nucleotide mutations [8%（5/60）] resulted in amino acid substitution in control group. Nueleotide mutations changed in position nt1632 and nt1635, located in non functional region.Conclusions HBV X gene mutations and the subsequent amino acid substitutions are found in HBV- GN. The urine protein excretion level increases in patients with X mutation, suggesting that these mutations may play an important role in the pathogenesis of HBV-GN.

关 键 词：肾炎 肝炎病毒 乙型 基因 突变 X基因 

分 类 号：R692.31[医药卫生—泌尿科学]