铜陵地区乙型肝炎病毒基因型分布与临床的相关性研究  

Distribution and Clinical Significance of Hepatitis B Virus Genotypes in Patients in Tongling

作　　者：唐吉斌[1] 翁伟[1] 张盛[1] 宋有良[2] 焦瑞宝[1] 章文[1] 

机构地区：[1] 铜陵市人民医院临床检验中心,安徽铜陵244009 [2] 铜陵市人民医院感染疾病科,安徽铜陵244009

出　　处：《现代检验医学杂志》2014年第2期70-72,75,共4页Journal of Modern Laboratory Medicine

基　　金：铜陵市卫生局基金资助项目（项目编号：卫科研201013）.

摘　　要：目的 了解铜陵地区乙型肝炎病毒（HBV）基因型分布,分析该地区HBV不同基因型别与肝功能损害、病毒复制水平及血清标志物的关系,探讨不同基因型的临床意义.方法 采用聚合酶链式反应-反向点杂交法（polymerase chain reaction-reverse dot blot,PCR-RDB）对铜陵地区228例ABV阳性感染者的血清分别进行HBV基因型的分型、HBV-DNA载量以及HBV血清标志物和肝功能等的检测,并结合其指标进行相关性分析.结果 在228份患者的血清样本中,226份样本成功分型,其中B型54.4％（124/228）,C型37.3％（85/228）,B/C混合型7.5％（17/228）,2例未检出占0.88％（2/228）.在各临床分型的慢性HBV感染者中,B基因型在慢性乙型肝炎组（CHB）、肝硬化组（LC）和原发性肝细胞癌组（HCC）中的构成比依次为61.8％,36.4％和60％,C基因型依次为25.7％,63.6％和40％,B型在CHB组占优势（χ^2=19.253,P=0.001）;C型在LC组占优势,差异有统计学显著性意义（χ^2=9.818,P＜0.001）.C基因型HBV-DNA载量明显高于B型及B/C混合型,差异具有统计学非常显著性意义（P＜0.01）.在不同基因型HBV患者中,除了性别,男性高于女性外,患者的生化指标经方差分析各组差异均无统计学显著性意义（P＞0.05）.结论 铜陵地区HBV基因型主要以B型为主,对HBV基因分型有助于了解患者的病情,对HBV感染患者的临床诊治具有重要指导意义.Objective To realize the distribution of HBV genotypes in Tongling area,and to analyse the relationships betweendifferent genotypes and liver function impairment and virus replication and serum markers, and to further investigate theclinical signifieance of different genotypes. Methods The serum from the 228 patients in Tongling area was applied to detectthe HBV genotypes,HBV-DNA load and HBV serum markers and liver function by the polymerase chain reaction-reversedot blot （PCR-RDB）,and the correlation analysis was used to determine whether the indexs were associated. Results A-mong the 228 serum samples,226 samples were successfully genotyped, in which the genotype B,the genotype C and thegenotype B/C hybridy acccounted for 54.4% （124/228）, 37.3% （85/228） and 7.5% （17/228） respectively,with 2 caseswere not detected aeecounting for 0.88 %. In various clinical types of chronic HBV-infected patients, the constituent ratios ofthe genotype B in the group of chronic hepatitis B （CHB） ,the group of liver cirrhosis （LC） and the group of hepatocellularcarcinoma group （HCC） were 61.8% ,36.4% and 60% individually,while the ratios of the genotype C in three groups were25.7% ,63.6% and 40% separately. The genotype B was dominant in the group of CHB （χ^2 =19,253,P=0. 001） ,when itcame to the genotype C,it showed superiority in the group of LC in which the difference was significant （X2 = 9. 818, P〈0. 001）. The HBV-DNA of the genotype C load was obviously higher than that of the genotype B and the genotype B/C hy-bridy which the difference was statistically significant （P〈0.01）. In the different genotype of HBV patients,in addition togender, the number of male was higher than female＇ s, and there was no significant differences in each group （P〈 0.05 ）.Conclusion The genotype B was mainly distributed in tongling area. HBV genotyping is beneficial to understanding the pa-tient＇s condition,which has a crucial role in clinical diagnosis and treatment of HBV-infected patients,

关 键 词：乙型肝炎病毒 基因型 乙型肝炎病毒-脱氧核糖核酸 聚合酶链式反应-反向点杂交法 

分 类 号：R512.686[医药卫生—内科学]