福建省部分地区乙型肝炎病毒基因型分布及其临床意义  

Distribution of hepatitis B virus genotype in 5 cities of Fujian province and the clinical implications of HBV genotype

作　　者：胡盈莹[1] 江家骥[1] 欧文湖[2] 林国贤 苏智军[4] 刘家俊[5] 李勤光[1] 姚履枫[1] 林彩文[1] 李丹[1] 陈怡[1] 

机构地区：[1]福州市传染病医院,350025 [2]三明市第一医院 [3]莆田市第二医院 [4]泉州市第一医院 [5]厦门市中医院

出　　处：《中华流行病学杂志》2004年第3期251-255,共5页Chinese Journal of Epidemiology

摘　　要：目的 首次调查福建省5个地区乙型肝炎病毒(HBV)基因型的分布状况,并探讨HBV基因型与HBV相关肝病临床的可能相关性。方法 收集福州市、厦门市、泉州市、三明市、莆田市等地区慢性HBV感染者的血清,采用聚合酶链反应-限制性片段长度多态性(PCR-RFLP)法检测HBV基因型,应用多因素logistic回归分析、对应分析研究HBV基因型与临床的相关性。结果 431例HBV DNA阳性血清中基因B型275例(63.8％)C型100例(23.2％),D型及其混合型共51例(11.8％),未见A、E、F型。多因素logistic回归分析显示,泉州和三明地区HBV基因B型所占比例显著高于福州地区(P=0.002;P=0.006);无症状携带者、慢性肝炎、重型肝炎组都是以基因B型为主要基因型;基因C型在肝硬化中所占比例(47.0％)显著高于无症状携带者(14.5％)和重型肝炎组(14.7％)(P=0.009;P<0.001);基因B型的e抗原阳性率(52.4％)显著低于C型(56.0％)(P=0.008);基因D型患者e抗原阳性率(30.8％)也低于C型(P=0.051)。对应分析表明原发性肝癌(HCC)与基因D型及其混合型关系密切。结论 (1)福建省HBV感染以基因B型为主,其次是C型,也存在基因D型的流行。(2)福建省部分地区基因型B和C的分布可能存在差异。(3)基因B型在年轻患者中可能与重型肝炎的发展有关;基因C型在年长患者中可能更易导致肝?Objective To study the prevalence of hepatitis B virus(HBV) genotype in 5 cities of Fujian province and the clinical implications of distinct genotypes in HBV--related liver diseases. Methods HBV genotype was determined by the restriction fragment length polymorphism analysis in patients with chronic HBV infection in 5 cities of Fujian province. The relationship between HBV genotype and its clinical implications was studied by multinomal logstic regression and correspondence analysis. Results Of the 431 HBV DNA positive patients detected by PCR, 275 (63. 8%) belonged to HBV genotype B, 100(23. 2%) to genotype C, 51 (11. 8%) to genotype D and D--mixed genotype. Genotype A, E and F were not found. Multinomal logistic regression showed that genotype B was more prevalent in Quanzhou and Sanming cities than in Fuzhou (P = 0. 002, P = 0. 006), and genotype B appeared significantly more common in asymptomatic carriers (ASC), chronic hepatitis B (CHB) and severe hepatitis (SH). Genotype C was most prevalent in patients with liver cirrhosis (LC) (47. 0%) than in those with ASC(14. 5%) and SH(14. 7%) (P = 0. 009, P< 0. 001). The positive rate of hepatitis B e antigen was higher in patients with genotype C than in those with genotype B and genotype D (56. 0% vs. 52. 4 %, P = 0. 008, and 56. 0% vs. 30. 8%, P = 0. 051, respectively). By correspondence analysis, genotype D and D--mixed genotype seemed to be correlated with hepatocellular carcinoma (HCC). Conclusions (1) The major popular genotypes of HBV were B, C and D in Fujian. (2) Data of our study suggested that the geographic distribution of genotype B and C might be different in some cities of Fujian. (3) Genotype B might have a tendency to lead to SH in younger patients with chronic hepatitis B and the development of LC might be associated with genotype C among the elder patients. (4) Genotype D appeared to a

关 键 词：福建 乙型肝炎 病毒基因 基因型分布 临床分析 

分 类 号：R446.5[医药卫生—诊断学]