耐药突变型乙型肝炎病毒感染者临床特征分析  

The clinical characteristics of chronic HBV infection patients with drug-resistant mutations

作　　者：李俐漫 刘洁[2] 刘明君 刘松梅[1] LI Li-man;LIU Jie;LIU Ming-jun;LIU Song-mei(Center for Gene Diagnosis,Zhongnan Hospital,Wuhan University,Wuhan 430071,China;Department of Clinical Laboratory,Hospital of Traditional Chinese Medicine of East Hubei Medical Group,Huangshi 435000,China)

机构地区：[1]武汉大学中南医院基因诊断中心,湖北武汉430071 [2]鄂东医疗集团黄石市中医医院(黄石市传染病医院)检验科,湖北黄石435000

出　　处：《实用医院临床杂志》2020年第1期168-170,共3页Practical Journal of Clinical Medicine

摘　　要：目的分析耐药突变型乙型肝炎病毒(HBV)感染患者HBV基因型、DNA拷贝数及肝功能、凝血功能临床特征。方法回顾性分析耐药型与敏感型、拉米夫定不同耐药突变位点患者HBV基因型、DNA拷贝数、肝功能、凝血功能的差异性。结果耐药型患者血清天门冬氨酸氨基转移酶(AST),总胆红素(TIBL),间接胆红素(UBIL),谷氨酰基转移酶(GGT),活化部分凝血活酶时间(APTT)均高于敏感组,纤维蛋白原(FIB)低于敏感组(P<0.05);两组HBV-DNA拷贝数比较,差异无统计学意义(P>0.05);LVDrt180M+rt204V/I突变组血清TP和GLB水平均低于rt204I突变组(P<0.05)。结论耐药型HBV感染者较敏感型肝功能、凝血功能受到更为严重的损害。拉米夫定不同耐药突变位点接受抗病毒药物的作用效果可能存在不同,应扩大数据进一步研究。Objective To characterize HBV genotype,HBV-DNA copy number,liver functions and coagulation functions in HBV infection patients with drug-resistant mutations.Methods In this retrospective study,the differences of HBV genotype,HBV-DNA copy number,liver functions,and coagulation functions between drug resistant and sensitive types,and lamivudine resistant mutation sites were analyzed.Results Serum aspartate aminotransferase(AST),total bilirubin(TIBL),indirect bilirubin(UBILl),glutamyltransferase(GGT)and activated partial thromboplastin time(APTT)were higher while fibrinogen(FIB)was lower in the drug resistant type than those in sensitive type(P<0.05).There was no difference in HBV-DNA copies between drug-resistant and sensitive types(P=0.556).For lamivudine-resistance sites,serum TP and GLB were significantly increased in patients with rt204I mutations when compared to those with rt180M+rt204V/I mutations.Conclusion Patients with drug-resistant-related mutations have more severe damage of liver and coagulation functions.The therapy effect of antiviral drugs may be different for patients with different lamivudine-resistant mutations.The results should be confirmed in further studies with larger sample size and in multiple centers.

关 键 词：耐药 HBV 临床特征 

分 类 号：R446.6[医药卫生—诊断学] R512.62[医药卫生—临床医学]