乙型肝炎病毒基因分型及临床应用研究  

Genotyping of hepatitis B virus and clinical investigation

作　　者：王永忠[1] 周国平[1] 李夏亭[1] 周志武[1] 周胜生[1] 阮丽花[1] 陈敏[1] 邓为群[1] 

机构地区：[1]江苏常州市第三人民医院肝病研究室,常州213001

出　　处：《中华实验和临床病毒学杂志》2002年第4期367-369,共3页Chinese Journal of Experimental and Clinical Virology

摘　　要：目的　了解常州地区乙型肝炎病毒基因型分布特征 ,探讨其基因型与肝功能损伤、病毒复制水平及对拉米夫定疗效的关系。方法　采用巢式聚合酶链反应 (nest PCR) ,扩增乙型肝炎病毒S基因区 ,用末端标记方法对PCR产物标记并直接测序 ,测序结果和GenBank中登录的标准基因型序列相比较。结果　对该地区 14 6份不同HBV感染者血清HBVDNA进行了基因分型 ,B型 5 1份 (34 9% ) ,C型 95份 (6 5 1% ) ,未发现B、C以外其他基因型 ;丙氨酸转氨酶 (ALT)水平分别为 383 8± 335 7IU和36 4 3± 333 7IU ,(t=0 335 ,P >0 .0 5 )、HBVDNA含量分别为 10 7 795± 1 2 2 和 10 7.6 9± 1 .1 9拷贝 毫升 (t=0 .138,P >0 0 5 )、HBeAg阳性数分别为 36 5 1和 6 4 95 ,(χ2 =0 .15 9,P >0 .0 5 ) ;10 4例慢性乙型肝炎中B型为 4 3例、C型为 6 1例 ,2 8例肝硬化和肝癌患者检出B型 4例、C型 2 4例 ,二组比较 χ2 =7 6 5 ,P <0 .0 1;2 3例B基因型患者和 4 5例C基因型患者接受 4 8周以上拉米夫定治疗 ,4 8周后反跳者B型为 18例 ,C型为 14例 ,χ2 =13.4 9,P <0 .0 0 1.结论　本地区HBVDNA基因型为B型和C型 ;二种基因型丙氨酸转氨酶水平、病毒复制水平和HBeAg表达水平差异均无显著性 ;C基因型与肝硬化和肝癌关系密切 ;拉米夫定对C?Objective To investigate the distribution of HBV genotypes in Changzhou area and to clarify the genotype related difference in the liver function,the level of HBV DNA and the long term effect of lamivudine in the pathogenicity of HBV. Methods Nested PCR and sequence analysis were conducted in 14 acute hepatitis (AH), 104 chronic hepatitis (CH), and 28 liver cirrhosis or hepatocellular carcinoma (LC/HCC) patients. Results One hundred and forty six samples were positive for HBV DNA, and 51 samples were classified as genotype B(34.9%), 95 samples were classified as genotype C, serum ALT value was 383.8±335.7IU in patients with HBV genotypes B, and 364.3±333.7 IU in genotypes C,HBV DNA value was 10 7.795±1.22 copies/ml in genotypes B and 10 7.69±1.19 copies/ml in genotypes C,and there were 36 and 64 HBeAg positive cases in patients with genotypes B and C; there were no significant difference on the level of ALT,HBV DNA and the expression of HBeAg ( P >0.05), but genotype C in LC/HCC was higher than CH ( P <0.01). Twenty three genotype B and forty five genotype C patients received lamivudine treatment, after 48 weeks, 18 genotype B and 14 genotype C patients had higher ALT or HBV DNA positive. Conclusion These results indicate that genotype B and C existin Changzhou area; genotype C is associated with the development of severe liver disease and better therapeutic effect could be obtained in the patients with genotype C.

关 键 词：临床应用 乙型肝炎病毒 基因型 聚合酶链反应 序列分析 拉米夫定 肝功能损害 病毒复制 

分 类 号：R373[医药卫生—病原生物学]