山东省潍坊市慢性乙型肝炎患者HBVP区基因耐药突变检测及相关因素分析  

The Drug Resistance Mutation Detection and Relevant Factors Analysis of HBV P Region in Chronic Hepatitis B Patients in Weifang City,Shandong Province

作　　者：赵建强[1] 刘加法[1] 

机构地区：[1]山东省潍坊市人民医院,潍坊261041

出　　处：《病毒学报》2015年第1期14-17,共4页Chinese Journal of Virology

摘　　要：探讨慢性乙型肝炎（Chronic hepatitis B,CHB）患者多聚酶基因逆转录保守区（P区）位点突变情况。选择212例行核苷（酸）类似物抗病毒治疗的CHB患者,采用PCR产物直接测序法检测HBV P基因区耐药变异位点,同时检测其HBV基因型。结果表明,HBV的P基因区突变位点有173、180、18l、184、204、236和250,主要的耐药位点为204和180,分别占35.8%和23.5%。180位点在不同年龄组之间比较均有显著差异,204位点在30岁以下组与41~50岁组、51~60岁组间比较有显著差异（P〈0.05,P〈0.01）;180位点联合204位点突变率为66.6%,l81位点联合236位点突变率为23.3%;HBV C基因型患者年龄明显大于B基因型患者（P〈0.01）。M204V/I多以联合L180M突变的形式存在,突变率与年龄有关,HBV基因型和HBV P区耐药位点的检测对CHB患者的治疗和病情预后具有重要的临床意义。In order to investigate the mutation of HBV polymerase gene reverse transcription conserved region（P region）in chronic hepatitis B（CHB）patients,212 CHB patients who took antiretroviral treatment with nucleotide analogues were chosen.The drug resistance mutations of HBV P region and HBV genotype were detected by Pyrosequencing.Sequence analysis showed that the drug resistance sites of HBV P region located at sites 173;180;181;184;204;236and 250.The main site of HBV P region drug resistance was 204 and 180,accounting for 35.8%and 23.5%,respectively.There were significant differences in the mutation rate of site 180 among different age groups.There were also significant differences in the mutation rate of site 204 among younger than 30 age group,41 to 50age group and 51 to 60age group.（P〈0.05,P〈0.01）;The mutation rate of site 180 combined with site 204 was 66.6%.The mutation rate of site 181 combined with site 236 was 23.3%.The age of C genotype infected patients was significantly older than B genotype infected patients（P〈0.01）.M204V/I mutation mostly existed in the form of joint L180 M mutation,the mutation rate was age-related.The detection of HBV genotypes and drug resistance sites of HBV P region have important clinical implications for the treatment and prognosis of patients with CHB.

关 键 词：慢性乙型肝炎 耐药 突变 HBV基因型 

分 类 号：R373.9[医药卫生—病原生物学]