慢性乙型肝炎拉米夫定耐药患者HBV基因型及ALT变化的观察

Clinical investigation on HBV DNA and ALT in patients with lamivudine - resistant chronic hepatitis B

观察慢性乙型肝炎患者用拉米夫定治疗后HBVP基因变异与不同HBV基因型感染及HBV DNA复升水平和转氨酶变化。收集51例慢性乙型肝炎患者用拉米夫定治疗52-78周后发生YMDD变异的血清标本,对照组128例未用拉米夫定治疗的慢性乙型肝炎患者血清标本,应用聚合酶链反应方法,测定HBV DNA基因型;用限制性片段长度多态性分析方法(PCR RELP)测定HBV DNA YMDD变异;同时进行HBV DNA定量分析。结果显示51例拉米夫定治疗后HBV DNA基因变异患者以B型和C型为主,分别为10例(19.6%)和39例(76.47%),B+C混和型2 例(3.92%),未见其它基因型。拉米夫定治疗引起HBV DNA YMDD变异可以发生在不同HBV基因型感染的慢性乙型肝炎患者中,与对照组比较二者没有显著性差异。

To elucidate the different responses in the chronic hepatitis B patients with different Hepatitis B Virus （HBV） genotypes after treatment with lamivudine, and to understand mutations in the HBV p region. Collected blood serum from fifty - one patients with chronic hepatitis B ＂after therapy by lamivadine for 52 - 78 weeks. 128 cases of Hcpatitis B without lamivudine trearqnent for control The YMDD motif mutation was dectected by PCR - RFLP, The HBV genotype was detected by the specific genotyping system for hepatitis B virus corresponding to six major genotypes by PCR using type- specific precifie primers. Serum levels of HBV DNA were measured. After treatment Fifty - one chronic hepatitis B patients were divided into three troups based on HBV genotypes. Numbers of genotype B,genotype C,and genotype B mixed C are 10 （19.6%）,39（76.47%）,2（3.92%） relatively. The results suggested that YMDD mutations caused by lamivudine could be observed in chronic hepatitis B patients with different HBV genotypes;Compare with the control group,there is no significant difference.