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目的 了解重型乙型肝炎（ 乙肝） 病人血清乙肝病毒（ＨＢＶ）ＤＮＡＣ基因启动子（ＣＰ） 的变异。方法 对用聚合酶链反应（ＰＣＲ） 法扩增的血清ＨＢＶＤＮＡ 直接测序。结果 ７ 例亚急性重型肝炎病人的ＨＢＶ 分离株ＣＰ区分别有２～１２ 个替代变异，１ 例病人有１１ｂｐ 的碱基插入。ＣＰ变异主要发生于ＣＰ的第１ 和第２ 个ＡＴ丰富区，ｎｔ１ ７６２ 和ｎｔ１ ７６４ 的替代变异见于７ 例亚急性重型肝炎病人的４ 例中，是ＣＰ变异的热点，其中３ 例ＨＢｅＡｇ 阴性，说明和ＨＢｅＡｇ 阴性表型相关。ＣＰ的第３ 个ＡＴ丰富区、ＨＢＶ逆转录起始位点（ＤＲ１） 和前Ｃ基因、前基因组转录起始位点未见变异。结论 重型肝炎病人的ＨＢＶＣＰ区存在较多的变异，ＣＰ变异主要发生于和前Ｃ基因相关的第１ 和第２ 个ＡＴ丰富区，可能和ＨＢｅＡｇ 阴性表型相关
Objective To understand the variation of DNAC gene promoter (CP) of hepatitis B virus (HBV) in patients with severe hepatitis B (hepatitis B). Methods Serum HBVDNA amplified by polymerase chain reaction (PCR) was directly sequenced. Results Seven to seven substitution mutations were found in the CP region of HBV isolates in seven patients with subacute severe hepatitis and one in 11 bp. CP mutation occurred mainly in the first and second AT rich region of CP, and the substitution mutation of nt1 762 and nt1 764 was found in 7 subacute severe hepatitis patients in 4 cases, which was the hot point of CP mutation. Among them, 3 cases were negative for HBeAg, Description and HBeAg negative phenotype related. The third AT-rich region of CP, HBV reverse transcription initiation site (DR1) and pre-C gene, the former genome transcription initiation site no mutation. Conclusion There are many variations in the HBVCP region of patients with severe hepatitis. The variation of CP mainly occurs in the first and second AT-rich regions associated with the pre-C gene, which may be related to the negative phenotype of HBeAg