苏州地区乙型肝炎患者P区耐药突变与临床指标的相关性分析  

Analysis of Correlation Between Drug-resistant Mutation in P-zone and Clinical Indicators in Patients with Hepatitis B in Suzhou Area

作　　者：郦芳华 胥萍[1] 徐俊驰[1] 宋华峰[1] LI Fang-hua;XU Ping;XU jun-chi;SONG Hua-feng(The Fifth People's Hospital of Suzhou,Suzhou Jiangsu 215007,China)

机构地区：[1]苏州市第五人民医院,江苏苏州215007

出　　处：《抗感染药学》2021年第10期1421-1424,共4页Anti-infection Pharmacy

基　　金：苏州市民生科技基金项目(编号:SS 201879,SS 2019074);苏州市医学重点专科(编号:SZXK 201814)。

摘　　要：目的:探究苏州地区乙型肝炎患者P区耐药突变情况,以及P区耐药与凝血功能、肝脏合成功能的相关性,分析其不同耐药突变对机体临床指标的影响。方法:选取苏州市第五人民医院2017年—2019年就诊的乙型肝炎患者410例中P区耐药突变检测资料;比较与分析其P区非突变组和突变组之间的凝血功能、肝脏合成功能指标的差异。结果:410例乙型肝炎患者中,P区耐药检测突变的有139例(占33.90%),其中耐药突变率较高的TOP 3位点分别是204 M (ATG)占22.30%、180 L(CTG)+204 M (ATG)占22.30%、180 L(CTG)+202 S(AGT)+204 M (ATG)占14.39%;同时,突变组凝血功能的APTT、PT、D-D水平明显高于非突变组(P<0.05),肝脏合成功能的白蛋白水平显著低于非突变组(P<0.05)。结论:乙型肝炎P区耐药突变位点主要是204 M(ATG)、180 L(CTG)和181 A(GCT),而且这三个耐药位点的突变往往还伴随着其他位点的突变;同时,乙型肝炎P区耐药突变对患者的凝血功能、肝脏合成功能均有着不同程度的影响。Objective: To study the drug-resistant mutations in P-zone in patients with hepatitis B in Suzhou area,and the correlation between drug resistance in P-zone and coagulation function and liver synthesis function, and to analyze the influence of different drug resistance mutations on clinical indicators. Methods: The detection data of drug resistance mutation in P-zone of 410 hepatitis B patients admitted to the Fifth People’s Hospital of Suzhou from 2017 to2019 were selected. The differences of coagulation function and liver synthesis function between non-mutant group and mutant group in P-zone were compared and analyzed. Results: In 410 patients with hepatitis B, 139 cases(33.90%)were found to have mutations in drug resistance in P-zone. The TOP 3 loci with high resistance rates were 22.30% at204 M(ATG), 22.30% at 180 L(CTG)+204 M(ATG), 14.39% at 180 L(CTG)+202 S(AGT)+204 M(ATG). Meanwhile, the levels of APTT, PT and D-D of coagulation function in mutant group were significantly higher than those in non-mutant group(P<0.05), and the level of albumin of liver synthesis function was significantly lower than that in nonmutant group(P<0.05). Conclusion: The drug resistance mutation sites in P-zone of hepatitis B are 204 M(ATG), 180 L(CTG) and 181 A(GCT), and the mutations in these 3 drug resistance sites are often accompanied by mutations in other sites. At the same time, drug-resistant mutations in P-zone of hepatitis B have different degrees of influence on coagulation function and liver synthesis function.

关 键 词：乙型肝炎 P区耐药 凝血功能 肝脏合成功能 相关性 

分 类 号：R512.6[医药卫生—内科学] R915[医药卫生—临床医学]