乙型肝炎病毒C基因启动子和前C基因变异与HBeAg含量和肝炎病情的临床研究  

The effects of mutations in the core promoter and the precore gene of hepatitis B virus on serum content of antigen and the severity of chronic hepatitis B.

作　　者：张汉荣[1] 刘新钰[1] 孙梅[1] 赵巍[1] 曹利[1] 李敏[1] 王建芳[1] 吴引伟[1] 

机构地区：[1]南京市第二医院,江苏南京210003

出　　处：《临床肝胆病杂志》2003年第5期290-291,共2页Journal of Clinical Hepatology

摘　　要：研究乙型肝炎病毒(HBV)C基因启动子(CP)和前C基因变异对HBeAg表达和病情的影响。通过DNA扩增、基因序列分析检测48例慢性乙肝和12例慢性重型乙肝患者血清的HBV CP和前C基因序列,及通过微粒子发光法定量检测血清中HBeAg的含量。(1)前C终止变异(nt1896G→A)在重型乙型肝炎病例中的发生率显著升高(66.7％);CP双变异(nt1762A→T和1764G→A)则在慢性乙型肝炎中度和重度的病例中的发生率显著升高(分别为52.6％和54.5％)。(2)双变异组和终止变异组的HBeAg含量均显著下降,P<0.01。但终止变异组HBeAg含量的下降较双变异组更为明显,P<0.05,且eAb阳性率也显著升高,P<O.05。终止变异联合双变异组的HBeAg含量及eAb阳性率同终止变异组相近。前C终止变异对HBeAg表达的影响较CP双变异更大,对肝炎病情的影响也更明显。To study the effects of mutations in the core promoter (CP) and the precore gene of hepatitis B virus (HBV) on serum content of e antigen and the severity of chronic hepatitis B. CP and precore gene were sequenced directly from sera of 48 cases of patients with chronic hepatitis B(CH) and 12 cases of patients with severe chronic hepatitis B(CSH) after amplication by the poly-merase chain reaction. The result: (l)The rate of incidence of defects in the precore region mutation (nt 1896G→A)was significantly increased in severe chronic hepatitis B (66.7%), rate of incidence in CP double mutation (nt 1762A→T and 1764G→A) was significantly increased in middle and severe degree of CH (52.6% and 54.5% ). (2)Content of e antigen from sera of patients with the double mutations and /or defects in the precore region was significantly lower than that of patients without the mutations. But, the decrease of content of e antigen from sera of patients with defects in the precore region was more significant than that of patients with the double mutations, and manifested HBeAg negative and anti - HBe positive in sera. Defects in the precore region and the double mutations decrease or block synthesis of HBeAg, and is related to the severity of chronic hepatitis B. The effect of defects in the precore region is more significant than that of the double mutations.

关 键 词：乙型肝炎病毒 C基因启动子 前C基因 基因变异 HBEAG 

分 类 号：R512.62[医药卫生—内科学] R394[医药卫生—临床医学]