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目的探讨重型肝炎(重肝)乙型肝炎病毒(HBV)基因型与基本核心启动子(BCP)及前C区突变的关系。方法采用聚合酶链反应(PCR)-限制性片段长度多态性分析技术(PCR-RFLP)对52例重肝和52例慢性乙肝(CHB)进行HBV基因分型。采用PCR产物直接测序技术,随机对15例B型和15例C型重肝患者的BCP区和前C区进行序列测定,分析HBV基因型与BCPT1762/A1764及前C区A1896突变的关系。结果泉州地区重肝的基因型以B型为主(48.08%),其次为C型(30.77%)和B/C混合型(17.31%),无A、E、F型存在。与CHB组比较,重肝组B型检出率明显降低,而C型和B/C混合型检出率明显升高。C型重肝患者BCPT1762/A1764双突变率显著高于B型(P<0.05),而前C区A1896突变率在B、C型感染者中差异无统计学意义(P>0.05)。结论C型感染易引起较重肝损伤,而B/C型混合感染可能是导致重肝发生的重要原因之一。C型重肝患者BCPT1762/A1764双突变率显著高于B型。
Objective To investigate the relationship between the hepatitis B virus (HBV) genotype of severe hepatitis (severe hepatitis) and the mutations of basic core promoter (BCP) and pre-C region. Methods HBV genotypes were determined in 52 cases of severe hepatitis B and 52 cases of chronic hepatitis B (CHB) by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP). Sequencing of BCP and precore C in 15 cases of type B and 15 cases of type C severe hepatitis were carried out by PCR direct sequencing. The relationship between HBV genotypes and BCPT1762 / A1764 and precancerous A1896 mutations was analyzed. Results The genotypes of heavy liver in Quanzhou were mainly B type (48.08%), followed by C type (30.77%) and B / C mixed type (17.31%). There were no A, E and F types. Compared with CHB group, the detection rate of type B in patients with severe hepatitis was significantly lower, while the detection rate of mixed type C and B / C was significantly higher. The double mutation rates of BCPT1762 / A1764 in patients with severe hepatitis C were significantly higher than those in patients with type B (P <0.05). However, there was no significant difference in the mutation rate of A1896 in patients with type C and C before infection (P> 0.05). Conclusion C-type infection can cause severe liver injury. B / C-type mixed infection may be one of the important causes of HCC. The double mutation rates of BCPT1762 / A1764 in patients with severe hepatitis C were significantly higher than those in patients with type B.