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研究HBV DNA前C区基因突变与HBe系统的关系。方法:对88例慢性乙型肝炎患者进行HBVDNA基因检测(PCR法)、分子克隆及序列分析。结果:88例患者中,血清HBV DNA阴性22例,阳性66例。从阳性患者中检出野生株感染22例,占33.3%;突变株感染44例,占66.7%。44例突变株感染者中38例属1898位点及/或1901位点突变,占86.4%;其他形式突变6例,占13.6%;66例血清HBV DNA阳性中,CHB 49例,LC 17例,突变株感染检出率分别为69.3%、58.8%,两者经统计学处理无显著性差异(P>0.05)。在HBe系统中,HBV DNA阳性患者属HBeAg(+)者44例,其中突变株检出率为75.0%(33/44),属抗HBe(+)者20例,其中突变株检出率为50.0%(10/20),两者经统计学处理有显著性差异(P<0.05)。结论:①在HBe系统中,HBeAg(+)患者的突变株检出率高于抗HBe(+)患者(p<0.05),提示其位点突变株在HBeAg(+)中占优势,与以往文献报道中关于1896位点突变株主要存在于抗-HBe(+)患者中的结论不尽相同。因此,应考虑HBeAg(+)患者也存在病毒突变的可能。②HBV慢性感染过程中,CHB患者与LC患者的突变株感染检出率无显著性差异(P>0.05).表明在1898及/或1901位点的突变株感染与肝脏损害程度无平行关系。
To study the relationship between HBV DNA pre-C gene mutation and HBe system. Methods: HBVDNA gene was detected in 88 patients with chronic hepatitis B (PCR), molecular cloning and sequence analysis. Results: Among the 88 patients, serum HBV DNA was negative in 22 cases and positive in 66 cases. In positive patients, 22 cases of wild-type infection were detected, accounting for 33.3%. Mutant strains were infected in 44 cases (66.7%). Of the 44 cases of infection, 38 were genotype 1898 and / or 1901, accounting for 86.4%, 6 were other forms, accounting for 13.6%. Of the 66 cases with positive HBV DNA, 49 were CHB, and 17 were LC , And the detection rate of the mutant strains was 69.3% and 58.8% respectively. There was no significant difference between the two strains (P> 0.05). In the HBe system, HBV DNA positive patients were HBeAg (+) 44 cases, of which the mutation detection rate was 75.0% (33/44), is an anti-HBe (+) in 20 cases, of which the mutation detection rate 50.0% (10/20), both statistically significant differences (P <0.05). Conclusions: ① In HBe system, the mutation rate of HBeAg (+) patients is higher than that of anti-HBe (+) patients (p <0.05), suggesting that the mutant strains of HBeAg (+) predominant in HBeAg Reported in the literature about 1896 point mutations in anti -HBe (+) patients are mainly different conclusions. Therefore, it should be considered HBeAg (+) patients also have the possibility of virus mutation. (2) During HBV chronic infection, there was no significant difference in the detection rate of mutants between CHB patients and LC patients (P> 0.05), which indicated that there was no parallel relationship between the infection of mutants at 1898 and / or 1901 and the extent of liver damage.