延安市乙型肝炎病毒基因型分子流行病学研究

Molecular Epidemiologic Study of Hepatitis B Virus Genotypes in Yanan

目的了解延安市乙型肝炎病毒(HBV)的基因型流行及分布情况,探讨HBV基因型与其预防治疗的临床意义。方法采用反向杂交(RDB)技术对延安市122份HBVDNA阳性血清进行基因分型。结果在随机选取的122例HBVDNA阳性患者中,可检出基因型121例,检出率是99.18%,其中C型116例。C基因型患者的年龄、ALT水平及HBVDNA载量与B、D基因型没有显著性差异(P>0.05)。C基因型患者不同临床型之间HBsAg、HBsAb、HBcAb水平上比较没有显著性差异(P=0.170,0.280,0.418),但HBV携带状态组其HBeAg水平显著高于慢性乙型肝炎组(P=0.000),且在HBeAg、HBeAb和HBV-DNA水平与肝炎肝硬化组比较具有显著性差异(P=0.000,0.000,0.000);慢性乙型肝炎组在HBeAg、HBeAb和HBV-DNA水平上与肝炎肝硬化组比较也具有显著性差异(P=0.005,0.001,0.009)。男女性别在年龄及HBVDNA含量上比较均没有显著性差异(P=0.587,0.081),但在ALT水平上比较具有显著差异(P=0.015)。C基因型在年龄≥35岁组中所占的比例(97.83%)高于其在年龄<35岁组中的比例(94.67%),但差异无统计学意义(P=0.390)。结论延安市乙型肝炎病毒基因型有基因型B、C、D和B/C型,其中基因型C为优势基因型。

Objective To understand the distribution and prevalence of hepatitis B genotype in Yan'an,and approach clinical significance between hepatitis B genotype and prevention-treatment.Methods Based on Reverse dot blot(RDB)for HBV genotyping from 122 share of positive blood serum in Yanan.Results The 121 serum samples could be detected genotype and the detected rate was 99.18%.The genotype C was 116 samples.The age、ALT value and HBV capacity among C、B and D were not obvious differences(P>0.05).The patients of genotype C on the value of HBsAg、HBsAb、HBcAb were not obvious differences among clinical phenotypes(P=0.170,0.280,0.418),but the group of surface antigen carrier state was obvious difference in HBeAg value vs.the group of chronic hepatitis B(P =0.000),and it had obvious differences in HBeAg、 HBeAb and HBV-DNA value vs.hepatitis cirrhosis(P=0.000,0.000,0.000).There were also obvious differences in HBeAg、 HBeAb and HBV-DNA value between chronic hepatitis B and hepatitis cirrhosis(P=0.005,0.001,0.009).By sex,there were no obvious differences in age and capacity of HBV DNA,but on the ALT level,there was obvious difference(P=0.015).The ratio of genotype C in over 35-years age group was higher than that in under 35 group,but there were no obvious(P=0.390).Conclusions Only genotype B,C,D and B+C could be found in patients with chronic HBV infection in Yan'an,and genotype C was the dominant one.