儿童慢性乙型肝炎患者HBV前C/基本核心启动子区基因变异特点研究  

Gene mutations of hepatitis B virus precore/basalcore promoter region in children with chronic hepatitis B virus infection

作　　者：储芳 钟彦伟 杨红艳 王丹 温梦凡 刘超 孙群兰 李晶 张明 官卉卉 王文波 张敏 CHU Fang;ZHONG Yan-wei;YANG Hong-yan;WANG Dan;WEN Meng-fan;LIU Chao;SUN Qun-lan;LI Jing;ZHANG Ming;GUAN Hui-hui;WANG Wen-bo;ZHANG Min(Pediatric Liver Disease Therapy Research Laboratory,the Fifth Medical Center of Chinese PLA General Hospital,Beijing100039,China)

机构地区：[1]中国人民解放军总医院第五医学中心青少年肝病诊疗与研究中心,北京100039

出　　处：《传染病信息》2018年第6期541-543,576,共4页Infectious Disease Information

基　　金：北京市科技计划课题(Z171100001017182)

摘　　要：目的探讨慢性乙型肝炎(慢乙肝)患儿HBV前C(procore, PC)/基本核心启动子(basic core promoter,BCP)区的变异特点。方法收集符合慢乙肝和肝硬化诊断标准的患儿血清166例。采用DNAout方法提取血清HBV DNA;巢式PCR方法扩增HBVPC/BCP区序列,PCR产物纯化后直接测序。分析HBVPC/BCP区相关位点变异情况。结果 166例患儿中,HBV B基因型的患儿占比20.83%,HBV C基因型的患儿占比79.17%。在感染HBV B基因型的患儿中,乙型肝炎(乙肝)肝硬化患儿与慢乙肝患儿的HBV DNA水平无明显差异,但前者G1899A位点突变率高于后者。在感染HBV C基因型的患儿中,与慢乙肝患儿相比,乙肝肝硬化患儿发生A1762T/G1764A、G1896A突变的比率明显升高且ALT水平较高。结论 HBV C基因型,ALT水平升高,发生A1762T/G1764A,G1896A位点变异的患儿,更容易发展为乙肝相关肝硬化。Objective To investigate the characteristics of HBV precore(PC)and basal core promoter(BCP)region gene mutations in children with chronic hepatitis B(CHB).Methods A total of166children with CHB and liver cirrhosis(LC)were enrolled in this study and their serum samples were collected.Serum HBV DNA was extracted with DNAout method;the sequence in HBV PC/BCP region was amplified with nested PCR method,and PCR products were determined by direct sequencing after purification.Mutations of the HBV PC/BCP region were analyzed.Results Among the166children,20.83%of cases had HBV genotype B and79.17%of cases had HBV genotype C.In children of HBV genotype B infection,there was no significant difference in HBV DNA levels between LC children and CHB children,but the G1899A mutations were prevalent in LC children.In children of HBV genotype C infection,the A1762T/G1764A,G1896A mutations were significantly prevalent and alanine aminotransferase level was also incr eased in LC children compared with CHB children.Conclusions Children patients with HBV genotype C virus,high alanine aminotransferase,A1762T/G1764A,G1896A mutant virus are more susceptible to develop HBV-related LC.

关 键 词：儿童 慢性乙型肝炎 前C区 基本核心启动子区 变异 

分 类 号：R373.21[医药卫生—病原生物学]