内蒙古自治区呼和浩特地区乙型肝炎患者HBV基因分型、耐药突变的相关性分析  

Correlation of HBV genotyping and drug resistance mutation in Hohhot, Inner Mongolia

作　　者：郑小华 赵鹏伟 贾海琴 Zheng Xiaohua;Zhao Pengwei;Jui Haiqin(Department of Clinical Laboratory, the Peoples Hospital of Inner Mongolui Autonomous Region , Hohhot, Inner Mongolia 010017, China;Pathogenic Microbiology Laboratory, School of Basic Medical Sciences of Inner Mongolia Medical University, Hohhot, Inner Mongolia 010059, China)

机构地区：[1]内蒙古自治区人民医院检验科,呼和浩特010017 [2]内蒙古医科大学基础医学院病原微生物实验室,呼和浩特010059

出　　处：《中国基层医药》2019年第8期956-959,共4页Chinese Journal of Primary Medicine and Pharmacy

摘　　要：目的探讨内蒙古自治区呼和浩特地区慢性乙型肝炎患者病毒脱氧核糖核酸(HBV-DNA)载量与血清标志物水平间的关系,基因分型与核昔(酸)类似物耐药突变情况方法选取内蒙古自治区人民医院2015年1月至2017年12月确诊的慢性乙型肝炎患者193例为研究对象,采用实时荧光定量聚合酶链式反应(PCR)法检测HBV-DNA载量,分析其与血清学标志物的相关性。并从193例患者中选取79例采用PCR-反向点杂交法检测HBV基因分型和耐药突变,分析不同基因型患者的耐药突变情况。结果e抗原阳性和阴性患者的e抗体水平与HBV-DNA载量比较差异均有统计学意义(均P<0.001). 79例HBV感染者中,B基因型9例(11.4%),C基因型70例(88.6%)。其中有25例发生不同位点变异,变异率为31. 6%(25/79),以单位点rtS213T突变为主,约占24.0%(6/25)。结论呼和浩特地区慢性乙型肝炎患者的HBVDNA载量与e抗原、e抗体水平相关;基因型主要为B和C型,以C基因型为多;慢性乙型肝炎患者主要对拉米夫定、阿德福韦酯耐药,突变以rtS213T为主,也有混合位点的突变。Objective To investigate the relationship between HBV - DNA load and serum markers in chronic hepatitis B ( CHB) patients in Hohhot, Inner Mongolia, and to explore the mutation of HBV genotype and nucleoside analogue. Methods From January 2015 to December 2017,one hundred and ninety - three CHB patients hospitalized in the Peoples Hospital of Inner Mongolia were selected randomly. The clinical diagnostic criteria for all admitted patients were based on the " Guidelines for the Prevention and Treatment of Chronic Hepatitis B" jointly formulated by the Infectious Diseases Society of 2010. The HBV - DNA load of HBV was detected by real - time quantitative PCR, and the correlation between HBV - DNA load and serum markers was analyzed. Seventy - nine patients were selected from 193 hospitalized patients, PCR - reverse dot blot hybridization was used to analyze HBV genotyping and the drug resistance mutations of different genotypes. Results The differences of HBeAb level and HBV - DNA load between HBeAg positive patients and negative patients were statistically significant( all P <0. 001 ). Of 79 serum specimens of HBV infected people, 9 cases ( 11.4%) were B genotypes, and 70 cases of C genotype (8& 6%). Of them ,25 cases had different loci variation, the rate of variation was 31.6%(25/79), with the unit point rtS213T mutation dominated, accounting for about 24. 0%(6/25 ). Conclusion In Hohhot Inner Mongolia patients with CHB, HBV - DNA load with HBeAg and HBe Ab level are correlated;genotype in patients including B type and C type, which is mainly genotype C;patients with CHB mainly had drug resistance to lamivudine and adefovir dipivoxil, mutations including rtS213T,and hybrid mutation.

关 键 词：肝炎 乙型 慢性 肝炎病毒 乙型 基因 病毒 脱氧核糖核酸 肝炎e抗原 乙型 肝炎表面抗原 乙型 肝炎核心抗原 乙型 基因型 耐药突变 

分 类 号：R512.62[医药卫生—内科学]