摘要
[目的 ]探讨慢性乙型肝炎病毒C区基因突变株对干扰素治疗的应答反应 .[方法 ]对 5 8例慢性乙型肝炎患者用重组干扰素 α(总用量 5 2 2× 10 6U)治疗 .前C区基因停止密码 2 8的突变株由限定酶断片长短的多形性测定 .C区基因的变异是用增殖各患者的 5种乙型肝炎病毒DNA克隆的方法检测 .[结果 ]干扰素疗程结束 6个月后 ,前C区变异株 2 3例中 14例 (6 0 % )乙型肝炎病毒e抗原阴转 ,无变异的野生型 35例中 15例 (4 3 % )乙型肝炎病毒e抗原阴转 ,二组无显著性差异 ,而前C区野生型 35例中C区基因 5个克隆全变异组 (2 4例 )的乙型肝炎病毒e抗原阴转率高于C区基因 5克隆中至少 1个克隆未变异组 (11例 ) (5 8%与 9% ) .[结论 ]感染乙型肝炎病毒变异株的乙型肝炎病毒e抗原阳性患者对干扰素应答良好 ,但这种变异株并不一定非在前C区 ,而C区基因的变异株亦可通过干扰乙型肝炎病毒e抗原的合成和分泌 。
OBJECTIVE To evaluate the response to interferon treatment in chronic hepatitis B patients with the mutation of core promoter. METHODS Fifty eight consecutive patients with chronic hepatitis B were treated with the recombinant α interferon (total dose:522×10 6U). The mutation for stop codon 28 in the precore region was determined by restriction fragment length polymorphism and mutations in the core promoter were searched with five HBV DNA clones propagated from each patient. RESULTS HBeAg was cleared at 6 months after used the interferon in 14 (60%) of 23 patients with the precore mutation and in 15(43%) of 35 without it. Out of 35 patients, 24 patients with mutations in the core promoter in all five HBV DNA clones lost HBeAg more frequently than the remaining 11 patients with at least one clone of lacking mutation (58% VS 9%). CONCLUSION HBeAg positive patients infected with HBV variants could respond better to interferon by clearing HBeAg from serum. Such mutations may not necessarily be in the precore region but also in the core promoter, which would interfere with the synthesis and secretion of HBeAg either at the translation or transcription level.
出处
《延边大学医学学报》
CAS
2000年第3期179-182,共4页
Journal of Medical Science Yanbian University
