摘要
目的研究慢性乙型肝炎病毒(HBV)前C区G1896A变异、基本核心启动子(BCP)A1762T/G1764A变异及二者联合变异在HBeAg阴性和HBeAg阳性慢性乙型肝炎(CHB)患者中的变异特点及与病情进展的关系。方法将120例HBV DNA阳性CHB患者分为A、B两组,A组为HBeAg阴性CHB患者60例,B组为HBeAg阳性CHB患者60例,用荧光定量PCR检测A、B两组HBV DNA水平,用直接测序法检测A、B两组前C区G1896A及BCP区A1762T/G1764A变异的发生率。根据前C区及BCP区测序结果又分为变异组和无变异组,分析前C区及BCP区变异发生与病情进展的关系。结果 120例HBV DNA阳性CHB患者中A组检出变异株47例,B组检出变异株15例,A组和B组CHB患者中G1896A变异检出率分别为40.0%和10.0%(χ2=14.40,P=0.000);A1762T/G1764A变异检出率分别为38.3%和15.0%(χ2=8.35,P=0.003);联合变异的检出率分别为21.7%和0%(χ2=14.58,P=0.000)。120例CHB患者中G1896A、A1762/G1764A、联合变异的变异组HBV DNA含量明显高于无变异组HBV DNA含量,P<0.05,差异有统计学意义。HBeAg阴性CHB患者轻、中、重度不同病情中,G1896A变异、A1762T/G1764A变异及联合变异的变异组与无变异组比较,差异有统计学意义(P<0.05)。结论 (1)HBV前C区G1896A变异和BCP区A1762T/G1764A变异是导致HBeAg阴性、HBV DNA持续阳性的主要机制之一。(2)HBV前C区G1896A变异和BCP区A1762T/G1764A变异可能加重HBeAg阴性CHB患者病情的发展。
Objective To study the characteristics of hepatitis B virus（HBV） precore G1896A and basal core promoter（BCP） A1762T/G1764A mutation or their united mutation（G1896A and A1762T/G1764A mutation together） between HBeAgnegative and HBeAg-positive patients with chronic hepatitis B（CHB）.To analyze the clinical significance of HBV precore G1896A and BCP A1762T/G1764A mutation or their united mutation in the patients with HBeAg-negative CHB,to explore the relationship between HBV precore G1896A and BCD A1762T/G1764A mutation with CHB.Methods 120 CHB patients with HBV DNA（＋） were collected and divided into three groups：the group A（60 CHB patients with HBeAg-negative） and the group B（60 CHB patients with HBeAg-positive）.Viral loads of HBV DNA in sera were demonstrated using real-time quantification PCR.The rates of precore G1896A mutation and BCP A1762T/G1764A mutation in CHB patients in the group A and B were detected using poly merase chain reaction（PCR） and sequencing the products directly.120 CHB patients were also divided into mutation group and nonmutation group according to HBV precore and BCP sequence results.Results 47 cases of HBV mutation were detected in the group A and 15 cases of HBV mutation were detected in the group B.The incidences of precore region G1896A mutations were 40.0%（24/60） and 10.0%（6/60）（χ2=14.40,P =0.000） in the group A and B respectively.The incidences of A1762T/G1764A mutation were 38.3%（23/60）and 15.0%（9/60）（χ2=8.35,P=0.003） in the same patients respectively.The rate of the united mutation was 21.7% only in the group A（χ2=14.58,P=0.000）.The levels of HBV DNA viral loads in the group with G1896A mutation and A1762T/G1764A mutation and the united mutation were obviously higher than those of nonmutation group（P0.05）.In the mild,moderate and serious CHB patients with HBeAg-negative,the comparison between the groups of G1896A mutation,A1762T/ G1764A double mutation and the united mutation with the nonmutation groups showed statistical differences（P0.05）.Conclusion（1）The mutations of G1896A and A1762T/G1764A may be a major mechanism leading HBV DNA positive and HBeAg negative.（2）The mutations of G1896A and A1762T/G1764A may be associated with the severity of HBeAg-negative CHB.
出处
《现代医药卫生》
2012年第4期493-495,共3页
Journal of Modern Medicine & Health
