乙肝病毒感染孕妇病毒前C/C基因启动子区变异与肝脏炎症  

Occurrence of HBV precore / core promoter mutation and hepatic inflammation in pregnant women

作　　者：肖蕾[1] 刘惠媛[1] 杨湛[1] 李晶[1] 应若素[1] 张复春[1] 肖服兴[1] 许敏[1] 

机构地区：[1]广州市第八人民医院肝病科,510060

出　　处：《实用医学杂志》2015年第1期50-53,共4页The Journal of Practical Medicine

基　　金：广州市科技计划项目(编号:2010GN-E00221)

摘　　要：目的:调查孕妇所感染乙肝病毒(HBV)基因型及前C/C基因启动子区变异发生情况,以及变异与肝脏炎症的相关性。方法:PCR扩增111例HBV感染孕妇HBV S基因和前C/C基因启动子区序列,PCR产物经测序后与参考序列进行分析比对。结果 :111例孕妇中B基因型占54.1%(60/111),其余51例(45.9%)为C基因型。基因亚型中除B2、C1和C2外还存在C5和B4两种基因亚型。前C/C基因启动子区变异分析发现,该区段多个位点的变异均有发生,以A1762T/G1764A变异发生率最高。ALT大于正常上限者该区变异总体发生率高于ALT小于正常上限者,且A1846T和G1896A变异与HBe Ag阴性HBV感染相关。结论:感染HBV的孕妇其前C/C基因启动子区存在不同程度变异,且这些变异与HBe Ag的水平及肝脏的炎症活动相关。Objective To investigate the prevalence of hepatitis B virus （HBV） genotype and precore/ core promoter mutation in pregnant women, and the association of mutation with hepatic inflammation. Methods 111 pregnant women with chronic HBV infection was enrolled in this study. HBV S gene and precore/core promoter region were amplified by polymerase chain reaction （PCR）. The PCR products were sequenced and all sequences were aligned and analyzed with reference sequences. Results Of the total, 54.1% （60/111） of the women were infected with genotype B and the remaining 51 （45.9%） were infected with genotype C. Except for subgenotype B2, C1 and C2, subgenotype C5 and B4 were also identified. Sequences analysis showed mutation occurrence in preC/C promoter region, and A1762T/G1764A was the most prevalent mutation. The frequency of precore and core promoter mutations was higher in those pregnant women with ALT 〉 40 than that in those with ALT 〈 40. The A1846T and G1896A mutations were associated with HBeAg-negative infection. Conclusion The occurrence of precore and core promoter mutation can be detected in this region, and these mutations are associated with HBeAg level and hepatic inflammation.

关 键 词：肝炎病毒 乙型 基因型 前C/C基因启动子 变异 

分 类 号：R714.251[医药卫生—妇产科学]