乙肝病毒基因分型与HBV-DNA水平及临床表现的研究

Investigation of the relationship of hepatitis B virus gene type and HBV-DNA level with clinical manifestations

目的探讨HBV各基因型与DNA水平及HBeAg关系,分析不同基因型引起不同的临床表现。方法对108例HBV-DNA阳性患者进行基因分型、HBV-DNA定量检测、ELISA法检测HBeAg及肝功能检查后综合分析。结果基因分型为B型29例,C型51例,混合型16例,D型4例和未分型8例;C型HBV-DNA水平和HBeAg阳性率分别为(6.87±1.55)log值和74.51%,明显高于B型的(5.32±1.04)log值和44.83%(P<0.01);C型发展为慢性乙型肝炎(CHB)、肝硬化(LC)和原发性肝细胞癌(HCC)分别为49.0%、17.6%、13.7%,明显高于B型的41.4%、6.9%和3.4%(P<0.05);乙型肝炎病人中C型ALT、AST、TBIL和γG水平及发病年龄等均高于B型(P<0.05)。结论广州地区HBV基因型以C型为主,B型次之。C型HBV-DNA水平显著高于B型,B基因型HBeAg阳性率较C基因型高。C型肝脏损害比B型严重。

Objective To investigate the relationship between hepatitis B virus genotype and serum level of HBVDNA and HBeAg. analyze different HBV genotype leading to the change of clinical manifestations. Methods The genotype of HBV and serum level of HBVDNA in 108 patients positive for HBV DNA were determined. ELISA was used for detection of HbeAg and liver function was also examined. Results 29 patients were differentiated as genotype B, 51 genotype C, 4 genotype D, 16 mixed genotype and 8 undifferentiated. The clinical manifestations demonstrated that the serum level of HBVDNA HBeAg positive rate in patients of genotype C was 6.87 ± 1.55 and 74.51% higher than 5.32 ± 1.04 and 44.83 % in those of genotype B （ P 〈 0.01）. The occurrence rates of those developed to chronic hepatitis B liver cirrhosis and hepatoma in those of genotype C were 49.0%, 17.6% and 13.7 % higher than that of 41.4% ,6.9% and 3.4% in those of genotype B （P 〈 0.05）. The levels of ALT, AST, Thill, γG and age. of onset in those of genotype C were also higher than that of those of genotype B. Conclusion Genotype C is a predominated genotype and genotype B is the second in Guangzhou area. The serum level of HBVDNA in those of genotype C is higher than that of genotype B. The positive rate of HbeAg in those of genotype B is higher than that of genotype C. The damage to liver induced by genotype C is severe than that of genotype B.