乙型肝炎病毒基因型检测与肝炎临床的相关性

The detection of hepatitis B virus genotype and its clinical dependability

目的从分子水平探讨乙肝病毒基因型与HBVDNA水平、HBeAg阳性率的关系。方法采用微板核酸分子杂交ELISA法检测93例不同临床类型的乙肝患者的基因型。结果93例不同临床类型的乙肝患者中,以C基因型为主,其次为B基因型,部分以D型和混合型存在,无A、E、F型。按照亚急性乙型肝炎、慢性乙型肝炎、肝硬化的顺序,C基因型的检出率逐渐增高,B基因型的检出率逐渐降低。肝癌患者C基因型的检出率没有依次增高。C基因型HBVDNA(log值4.69±0.66)水平低于B型(log值5.33±0.66),但无统计学意义(P>0.05),而HBeAg阳性率C型(69.7%)大于B型(42%),且差别有统计学意义(P<0.05)。结论西安地区病毒性肝炎以C基因型为主,部分以B、D及混合型存在,未发现A、E、F型。除肝癌外,C型的检出率随临床类型的加重而增高,C型的HBVDNA水平低于B型,HBeAg阳性率显著高于B型。

Objective To investigate the relationship of hepatitis B virus genotype with the serum level of HBVDNA and the positive rate of HBeAg. Methods The genotype of HBV was detected by PCR ELISA in 93 patients with hepatitis B of different clinical types. Results Most of HBV genotype in Xi＇an was genotype C; some HBV genotypes were B, D and mixed genotypes. There was no A, E or F genotype. The percentage of genotype C increased according to the sequence of subacute hepatitis, chronic hepatitis （CH） and hepatitis B hepatocirrhosis, while the percentage of genotype B was decreased, but the percentage of genotype C in hepatocellar carcinoma （HCC） was not increased accordingly. The level of HBVDNA（4.69± 0.66） in genotype C was lower than that in genotype B（5. 33±0. 66） with no significant difference （P〉0.05）. The positive rate of HBeAg in genotype C（69.7%） was significantly higher than that in genotype B（42%） （P〈0.05）. Conclusion Most of the genotypes in Xi＇an are C, some of them are B, D and mixed genotypes, and there is no A, E or F. Except for HCC, the percentage of genotype C increases according to the severity of clinical type. The level of HBVDNA is lower than that in genotype B, but the positive rate of HBeAg in genotype C is significantly higher than that in genotype B.