核苷(酸)类似物治疗慢性乙型肝炎患者的HBV耐药位点分析  

Analysis of HBV Resistance Sites in Chronic Hepatitis B Patients Treated with Nucleoside (Acid) Analogues

作　　者：杨开余[1] Yang Kai-yu(Department of Gastroenterology,Guizhou Aerospace Hospital,Zunyi 563000,Guizhou Province,China)

机构地区：[1]贵州航天医院消化内科,贵州遵义563000

出　　处：《中国社区医师》2022年第25期163-165,共3页Chinese Community Doctors

摘　　要：目的:采用核苷类似物对乙型肝炎患者进行治疗,分析HBV基因耐药位点情况,为慢性乙型肝炎患者的临床治疗提供参考。方法:选取2018年12月-2019年12月在贵州航天医院接受核苷(酸)类似物治疗的慢性乙型肝炎患者105例为研究对象,先给予患者PCR反向点杂交检测,随后对患者的HBV基因分型进行明确,并检测患者的耐药变异位点,此过程分别采用HBV基因分型和耐药相关检测实现,分析检测结果。结果:105例慢性乙型肝炎患者中,检出HBV-B型基因耐药变异23例(21.90%),HBV-C型基因耐药变异81例(75.24%),HBV-其他型基因耐药变异3例(2.86%)。共检测出HBV基因耐药变异位点9个,分别为rtL80M、rtA181V、rtA181T、rtT194L、rtS204I、rtM204V、rtN236T、rt180M+rt204V/I、rtA181T+rtN236T;其中HBV-B型基因耐药变异位点检出率为91.30%,HBV-C型基因耐药变异位点检出率为94.94%,HBV-其他型基因耐药变异位点检出率为100.00%。结论:慢性乙型肝炎患者的HBV基因耐药变异位点多且复杂,不同HBV基因耐药性和变异位点也不尽相同,检测患者HBV基因耐药变异位点对临床制定患者治疗方案以及预后判断等具有重要意义。Objective:After nucleoside analogues were used to treat patients with hepatitis B,the drug-resistant sites of HBV genes were analyzed to provide reference for clinical treatment of patients with chronic hepatitis B.Methods:A total of 105 patients with chronic hepatitis B who received nucleoside(acid)analogue therapy in Guizhou Aerospace Hospital from December 2018 to December 2019 were selected as the study subjects.The patients were first tested by PCR and reverse dot hybridization,then the HBV genotyping in the patients was confirmed,and the drug-resistant variant sites in the patients were detected.This process was realized by using HBV genotyping and drug resistance-related testing,and the test results were analyzed.Results:Among the 105 patients with chronic hepatitis B,23 cases(21.90%)of HBV-B gene drug-resistant variants,81 cases(75.24%)of HBV-C gene drug-resistant variants,and 3 cases(2.86%)of HBV-other gene drug-resistant variants were detected.A total of 9 HBV gene drug-resistant variant sites were detected,namely rtL80M,rtA181V,rtA181T,rtT194L,rtS204I,rtM204V,rtN236T,rt180M+rt204V/I,rtA181T+rtN236T;the detection rate of HBV-B gene drug-resistant variant sites was 91.30%,the detection rate of HBV-C gene drug-resistant variant sites was 94.94%,and the detection rate of HBV-other gene drug-resistant variant sites was 100.00%.Conclusion:There are many and complex HBV gene drug-resistant variant sites in patients with chronic hepatitis B,and the drug resistance and variant sites of different HBV genes are also different.Detection of HBV gene resistance variant sites in patients is of great significance for the formulation of clinical treatment plans and prognosis determination.

关 键 词：核苷(酸)类似物 慢性乙型肝炎 HBV 耐药位点 

分 类 号：R512.62[医药卫生—内科学]