乙型肝炎病毒耐药突变位点与基因型及肝硬化相关性研究  

Correlation between drug-resistance mutation sites and genotype,as well as cirrhosis in patients with chronic hepatitis B

作　　者：郑璟 彭燕燕[1] ZHENG Jing;PENG Yan-yan(Department of Clinical Laboratory,Shantou Central Hospital,Guangdong 515000,China)

机构地区：[1]汕头市中心医院检验科,广东515000

出　　处：《肝脏》2022年第7期752-755,共4页Chinese Hepatology

基　　金：汕头市医疗卫生科技计划项目[汕府科(2020)5号]。

摘　　要：目的探讨乙型肝炎病毒(HBV)基因不同耐药位点的突变率与病毒基因型及患者肝硬化的关系。方法选取391例经核苷(酸)类似物(NA)抗病毒治疗的乙型肝炎患者为研究对象,根据基因型分为B型345例和C型46例两组,比较两组6个耐药位点(rtL180M、rtM204V、rtM204I、rtV207I、rtA181V、rtN236T)突变率、联合突变模式构成比;根据不同疾病进程分为慢性乙型肝炎组(342例)和肝硬化组(43例),比较两组6个耐药位点突变率。结果C基因型组的耐药位点rtL180M突变率(21.7%比7.0%)和联合突变模式rtM204V+rtL180M构成比(6/13比16.5%)均高于B基因型组(P<0.05);肝硬化组的rtA181V位点突变率高于慢性乙型肝炎组(7.0%比0.3%),差异有统计学意义(P<0.05)。结论HBV基因不同耐药位点突变率与不同基因型和肝硬化相关,检测乙型肝炎患者HBV耐药突变位点能为临床合理用药提供参考。Objective To investigate the correlation between mutation rates in different drug-resistance sites of hepatitis B virus(HBV)gene and genotype as well as cirrhosis.Methods A total of 391 patients with chronic hepatitis B(CHB)treated in our hospital were enrolled.All the patients were treated with nucleoside(acid)analogue(NAs),they were divided into 2 groups according to genotype:B genotype(345 cases)and C genotype(46 cases).Mutation rates of 6 drug-resistance sites(rtL180M,rtM204V,rtM204I,rtV207I,rtA181V,rtN236T)and ratios of multi-mutation types were compared between the 2 groups.The patients were divided into the CHB group and(342 cases)and cirrhosis group(43 cases)according to the existence of cirrhosis,and the mutation rates of 6 drug-resistance sites were compared between the 2 groups.Results The mutation rates of rtL180M(21.7%vs 7.0%)and rtM204V+rtL180M(46.2%vs 16.5%)in C genotype group were higher than those in B genotype group(P<0.05).The mutation rate of rtA181V in cirrhosis group was significantly higher than that in CHB group(7.0%vs 0.3%),(P<0.05).Conclusion Mutation rates of HBV gene at different drug-resistance sites are correlated with different genotypes and cirrhosis.Detection of drug resistance mutation sites in patients with CHB can provide reference for antiviral therapy in clinic.

关 键 词：乙型肝炎 耐药 基因型 核苷(酸)类似物 

分 类 号：R512.62[医药卫生—内科学] R575.2[医药卫生—临床医学]