使用/未用拉米夫定HBV慢性感染者中YMDD基序变异的检测  

The detection of hepatitis B virus YMDD motif mutation in patients chronically infected with HBV with/without lamivudine therapy

作　　者：钱健帮[1] 孙南雄[1] 张永祥[1] 杜绍才[2] 范晓峰 

机构地区：[1]南京医科大学第一临床医学院传染病学教研室,研究生210029 [2]北京大学医学部附属北京人民医院肝病研究所 [3]Division of Gastroenterology & Hepatology,Saint Louis University

出　　处：《江苏医药》2002年第6期408-409,I002,共3页Jiangsu Medical Journal

摘　　要：目的　探讨接受拉米夫定治疗的慢性乙型肝炎病毒 (HBV)感染者YMDD基序变异的分子生物学机理。方法　以RFLP法筛选HBVYMDD基序变异 ,阳性者作直接测序的方法 ,分别检测 1 9例正在应用拉米夫定治疗的慢性乙型肝炎患者以及 86例未用拉米夫定的HBV感染者的血清标本。结果　 1 9例正在应用拉米夫定治疗的患者中检测出 2例YMDD基序变异 ,测序结果分别为YIDD和YVDD变异。在 86例未用拉米夫定或其他抗病毒药物治疗的HBV感染者中检测出 3例YMDD基序变异 ,测序结果分别为YIDD 1例和YVDD 2例。结论　在未用拉米夫定的HBV感染者中同样存在着YMDD基序变异 。Objective To explore molecular mechanism responsible for the occurrence of HBV YMDD motif mutations in patients receiving Lamivudine therapy.Methods We studied 105 patients chronically infected with HBV,19 receiving lamivudine therapy and 86 without any antiviral therapy.The detection of HBV YMDD mutations has been performed with restriction fragment length poymorphism(RFLP)analysis of PCR products spanning HBV YMDD motif.Results In 19 patients who received lamivudine therapy,there were 2 cases having YMDD motif mutations,YIDD and YVDD respectively,which were subsequently confirmed by dircetly sequencing of PCR products.Among 86 patients without any anti viral therapy,three cases with YMDD motif mutations were identified, including one YIDD and two YVDD mutations, respectively.Conclusion The fact that YMDD motif mutations exist in the HBV infected subjects without using lamivudine therapy suggests that the occurrence YMDD motif mutations during lamivudine therapy may be the result of selection among HBV quasispecies.

关 键 词：乙型肝炎病毒 YMDD基序变异 拉米夫定 诊断 治疗 乙型肝炎 

分 类 号：R512.62[医药卫生—内科学] R978.7[医药卫生—临床医学]