PCR-反向点杂交法检测HBV耐药变异与基因型的探讨  

Study on PCR-reverse dot blot for detecting drug-resistance variation and gebotypes of hepatitis B virus

作　　者：张达衡[1] 陈红玲[1] 谭满胜 陈瑞林[1] 杨春媚[1] 

机构地区：[1]茂名市人民医院 [2]茂名市妇幼保健院

出　　处：《国际检验医学杂志》2014年第13期1716-1717,共2页International Journal of Laboratory Medicine

摘　　要：目的探讨PCR-反向点杂交法检测HBV耐药变异与基因型的相关性及HBV变异位点与肝功能指标、HBVDNA病毒载量的关系。方法筛选符合条件的462例服用核苷类药物治疗的慢性乙型肝炎患者血清标本,釆用PCR-反向点杂交法检测HBV的耐药突变位点以及基因型,并对HBV耐药变异与基因型、肝功能检测指标、HBV DNA病毒载量等指标进行相关性分析。结果在462例服用核苷类药物治疗的慢性乙型肝炎患者血清中检测耐药变异株45例,变异率约为9.74%;其中180M和204I/V突变株16例,35.5%;204V突变株6例,13.3%;204I突变株13例,28.9%;180V突变株3例,6.7%;181V突变株3例,6.7%;207I突变株1例,2.2%,236T突变株3例,6.7%。HBV基因型中B基因型105例,C基因型337例,B基因型和C基因型联合感染4例,D基因型0例,其他基因型2例。将检测结果与临床资料进行相关性分析:乙肝患者的耐药变异位点与基因型、肝功能指标ALT无相关性(P>0.05),与HBVDNA病毒载量有一定相关性(P<0.05)。结论 1.茂名地区的HBV基因型可能与其他南方地区的基因型有差异,以HBV-C基因型为主;2.PCR-反向点杂交法是一种快速、准确发现核苷类药物治疗后耐药位点的检测方法;3.通过临床资料分析显示乙肝患者的耐药变异位点与肝功能指标ALT间差异无统计学意义(P>0.05),即无相关性,HBV-DNA病毒载量间差异有统计学意义(P<0.05),即有一定相关性。Objective To study the correlation between the drug-resistance variation and the genotypes of hepatitis B virus （HBV）detected by the PCR-reverse dot blot and the relation between the HBV variation loci with the liver function indexes and HBV DNA viral loading.Methods The serum samples from 462 patients with chronic hepatitis B treated by oral nucleoside drugs were screened.The PCR-reverse dot blot was adopted to detect the drug-resistance gene mutation loci and genotypes.The correla-tion between the HBV drug-resistance mutant with the genotypes,liver function indexes and HBV DNA viral loads was performed. Results Among 462 patients taking nucleoside drugs for treating chronic hepatitis B,45 drug-resistance mutants were detected with the mutation rate of 9.74%;in which,16 cases （35.5%）were 180M and 204I/V mutant,6 cases（13.3%）were 204V,13 ca-ses（28.9%）were 204I mutant,3 cases （6.7%）were 180V mutant and 3 cases（6.7%）were 236T mutant.The HBV genotyping showed 105 cases of genotype B,337 cases of genotype C,0 case of genotype D and 2 cases of other genotypes.Conclusion （1）The HBVgenotypes in Maoming area may be different from the genotypes in other southern regions and is dominated by HBV-C geno-type.（2）The PCR-reverse dot blot method is a detection method for fastly and accurately finding the drug-resistance loci after nu-cleosides therapy.（3）The clinical analysis demonstrates that the drug-resistance mutation loci has no correlation with the liver func-tion index ALT（P 〉0.05）,but there was certain correlation between the drug-resistance mutation loci in hepatitis B and HBV DNA viral load（P 〈0.05）.

关 键 词：肝炎病毒 乙型 基因型 聚合酶链反应 

分 类 号：R512.62[医药卫生—内科学]