拉米夫定治疗乙型肝炎病毒感染中YMDD变异发生与HBV DNA水平的关系

The Study of YMDD Mutation in Patients of Different HBV DNA Levels in Lamivudine Treatment

目的 研究拉米夫定治疗乙型肝炎病毒感染中 YMDD变异发生与治疗前 HBV DNA水平的关系。方法 98例拉米夫定治疗的乙型肝炎病毒感染者 ,测定治疗前 HBV DNA水平 ,定期随访 ,分别以PCR和 PCR- RFLP法检测 HBV DNA水平和 YMDD变异。结果 2 5例病例出现 YMDD变异 ,出现的平均时间为 1 1 .2± 7.45 mo。按治疗前病毒 DNA水平分为 5× 1 0 2～ 5× 1 0 4,5× 1 0 5～ 5× 1 0 6,5× 1 0 6～ 5×1 0 8和大于 5× 1 0 8copies/ml四个组 ,YMDD发生率分别为 1 0 % ,1 3.3% ,33.3%和 5 8.3%。结论 乙肝患者进行拉米夫定治疗时 ,病毒 DNA水平越高 ,发生

Objective To study the relationship between pretreatment HBV DNA levels and YMDD motif mutation in hepatitis B virus (HBV) polymerase gene during lamivudine treatment.Methods 98 patients who had received lamivudine therapy for tow years were recruited.HBV DNA levels and YMDD mutation were determined in different therapy time by PCR and PCR-RFLP respectively.Results 25 cases were observed YMDD mutation.According to different pretreatment HBV DNA levels,5×10 2～5×10 4,5×10 4～5×10 6,5×10 6～5×10 8 and >5×10 8 copies/ml,the YMDD mutant rate was 10%,13.3%,33.3% and 58.3% respectively.Conclusion The YMDD mutant rate is higher in patients with higher HBV DNA level in lamivudine treatment.