杭州地区112例乙型肝炎病毒基因型分布调查及意义

Distribution and clinical significance of hepatitis B virus genotypes among 112 patients in Hangzhou District

目的了解乙肝病毒不同基因型的分布及其与病情的关系。方法收集杭州地区112例慢性乙型肝炎病毒感染者的血清和临床资料,用基因芯片测定HBV基因型,分析不同基因型与病情的关系。结果B型37例,C型69例,混合型(B+C)6例,没有发现其他基因型;无症状携带者以B基因型为主,慢性乙型肝炎、肝硬化和原发性肝癌以C基因型为主。C型、B型感染者的肝组织学炎症分级分别为2.11±1.44和1.59±1.02,纤维化分期分别为1.95±1.27和1.40±1.04;C型感染者HBVDNA水平(lg表示)为7.02±1.26,高于B型的5.62±1.02;C型感染者HBeAg阳性率(60.87%)高于B型的(32.43%),差异有显著性(P<0.05)。B型感染者年龄小于C型感染者(P<0.05)。结论112例乙型肝炎HBV基因型以C型为主,B型次之。C型感染者HBVDNA水平、HBeAg阳性率显著高于B型感染者,C型HBV感染所致的肝病更严重。

Objective To investigate the clinical epidemiology significance of hepatitis B virus （HBV）genotypes. Methods HBV genotypes were determined by DNA microarray method. Results 37 patients were differentiated as genotype B, 69 genotype C and 6 mixed genotypes. No other genotypes were found. Genotype B was predominant in asymptomatic HBV carders, while Genotype C was the most in chronic hepatitis, live cirrhosis and hepatocellular carcinoma. Hepatic tissue inflammation grade of genotype C and genotype B was 2.11±1.44 and 1.59±1.02, respectively; fibrosis stage was 1.95±1.27 and 1.40±1.04 respctively for genotype C and genotype B. There was statistic significance（P〈0.05）. The clinical manifestations demonstrated that the serum levels of HBV DNA in patients of genotype C（lg） were 7.02±1.26 were higher than those of genotype B patients, and HBeAg positive rate of genotype C patients （60.87%） was higher than that of genotype B （32.43%）.Patients with genotype B were much younger than those with genotype C（P〈0.05）. Conclusion Genotype C is a predominated genotype in 112 patients.The serum level of HBVDNA in those of genotype C is highter than that of genotype B. The damage to liver induced by genotype C is severe than that of genotype B.