慢性乙型肝炎HBV DNA前C区变异检测及其与干扰素治疗关系的研究

Detection of hepatitis B virus pre-C region mutation in cases of chronic hepatitis B and its relationship with IFN treatment

目的应用聚合酶链反应-限制性酶切片段长度多态性分析(PCR-RFLP)法检测慢性乙型肝炎HBV DNA前C区变异与干扰素(IFN)治疗的关系。方法将中国医科大学附属盛京医院1996—1997年收治的200例符合临床诊断标准的慢性乙型肝炎患者,随机分为治疗组和对照组,治疗组应用常规保肝药物加IFN-α共同治疗,对照组只应用常规保肝药物治疗,疗程为6个月。治疗前后分别收集两组患者血清,用PCR-RFLP法检测前C区1896位变异情况。结果治疗前,治疗组变异株检出率为20%(20/100),对照组变异株检出率为18%(18/100);两组变异株检出率相比差异无统计学意义(P>0.05)。治疗后,治疗组变异株病毒感染的慢性乙型肝炎者20例治疗有效率为60%(12/20),野毒株病毒感染的慢性乙型肝炎患者80例治疗有效率为50%(40/80);而对照组变异株、野毒株病毒感染的慢性乙型肝炎患者治疗有效率均为0。结论IFN治疗无诱发HBV前C区1896位变异的作用,IFN治疗变异株病毒感染的慢性乙型肝炎有效,IFN治疗变异株病毒感染的慢性乙型肝炎近期疗效与野毒株基本相同。

Objective To investigate the relationship between hepatitis B virus pre-eore region 1896 site mutation in eases of chronic hepatitis B and IFN-alpha treatment. Methods 200 patients with chronic hepatitis B were randomly divided into experimental group（ n = 100） and control group（ n = 100）. The patients in experimental group were treated with regu- lar liver-protective drugs and IFN-alpha, while Control group patients received only regular liver-protective drugs for 6 months. PCR-RFLP were used to detect hepatitis B virus（HBV） DNA with pre-C region 1896 site mutation in two grops pre and post treatment. Results The mutation rates before interferon treatment were 20% （20/100） and 18% （18/100） in experimental group and control group, respectly. After treatment, the effective rates in experimental group were 60% （12/20） and 50% （40/80） in Patients with Chronic Hepatitis B variant and wild strain virus Infection,respectly. The effective rate in experimental group was significantly higher than that in control group. Conclusion IFN-alpha therapy was not eorrelaled with genomic variability of the core region.