拉米夫定治疗慢性乙型肝炎后YMDD变异与Pre-S1抗原检测的临床意义  

THE ANALYSIS OF THE HBV YMDD MUTATION AND THE PRE-S1 PROTEIN IN CHRONIC HEPATITIS B AFTER LAMIVUDINE THERAPY

作　　者：田珊红[1] 张艳[1] 张翠华[1] 秦莉[1] 张宝[1] 石俊 

机构地区：[1]河北省唐山市传染病医院检验科,063021 [2]华北理工大学附属医院检验科

出　　处：《中国煤炭工业医学杂志》2015年第10期1696-1698,共3页Chinese Journal of Coal Industry Medicine

基　　金：唐山市科学技术研究与发展指导计划项目(编号111302036b)

摘　　要：目的研究拉米夫定治疗慢性乙型肝炎后乙肝病毒YMDD变异及Pre-S1抗原的变化。方法选择未发生YMDD变异的慢性乙型肝炎患者190例,予拉米夫定治疗6个月后检测其YMDD变异、Pre-S1抗原、AST、ALT及HBV-DNA,并分析Pre-S1抗原阳性。结果 190例慢性乙型肝炎患者经过拉米夫定治疗后发生HBV-YMDD变异率为35.3%。其中YMDD变异组Pre-S1抗原阳性率为67.16%(45/67),与YMDD非变异组(69.92%,86/123)比较差异无统计学意义。Pre-S1抗原阳性患者AST、ALT、HBV-DNA含量均明显高于Pre-S1抗原阴性者。结论 1慢性乙型肝炎患者应用拉米夫定抗病毒治疗可能发生YMDD变异。2YMDD变异的发生与Pre-S1抗原是否转阴无关,但Pre-S1抗原阳性的慢性乙型肝炎患者肝功能更容易受损。Objective To analyze the clinical value of the HBV YMDD mutation and the Pre- S1 protein chronic hepatitis B after Lamivudine therapy. Methods Totally 190 cases of chronic hepatitis B who did not have YMDD mutation were selected, and received Lamivudine for 6 months. The YMDD mutation, Pre -S1, HBV- DNA, AST and ALT were checked after 6 months therapy. Results Among 190 cases after 6 months therapy, 35.3% of them had YMDD mutation. There were 67.16% and 69.92% patients who showed positive Pre- S1 in YMDD mutation and non YMDD mutation patients respectively, and there was no significant deference. AST, ALT, HBV-DNA in positive Pre- S1 patients were more significantly higher than those in negtive Pre- S1 patients. Conclusions Patients with chronic hepatitis B may develop YMDD mutation after Lamivudine therapy. There was no relationship between the YMDD mutation and Pre - S1 antigen change after Lamivudine therapy.

关 键 词：拉米夫定 慢性乙型肝炎 乙型肝炎前S1抗原 YMDD变异 

分 类 号：R575.1[医药卫生—消化系统]