HBV基因型和慢性HBV感染者临床实验室检查结果之间的关系

Relationships between hepatitis B virus genotypes and clinical laboratory examinational results of patients with chronic hepatitis B virus infection

目的:检测乙型肝炎病毒(HBV)不同基因型在慢性无症状携带者(AsC)、慢性乙型病毒性肝炎(CHB)和原发性肝细胞癌(HCC)患者中分布;探讨感染不同基因型HBV导致患者的常用临床实验室结果以及肝脏纤维化指标之间的差别。方法:随机挑选62例AsC、89例CHB和86例HCC患者,采用实时荧光定量聚合酶链反应(FQ-PCR)结合双色荧光标记的Taqman MGB探针来鉴定HBV基因型。实验室检查结果和资料摘抄自患者病案。运用统计软件SPSS10.0对结果进行统计学分析,以P<0.05为差别具有统计学意义。结果:本地区,AsC和CHB患者以感染HBV B基因型为主,分别占80.65%和78.65%;HCC患者以感染C基因型为主,占70.93%。C基因型在HCC组的分布比例明显高于其它两组患者(P<0.001)。在AsC或CHB组内,感染不同基因型的患者常用临床实验室检查指标未显示出明显差别。而在HCC患者中,感染C基因型患者较B基因型e抗原阳性率高(P<0.05)。在CHB和HCC组内感染C基因型较B基因型患者血清HA、LN、PCⅢ含量明显增高(分别为P<0.01,P<0.05和P<0.05),而AsC内均未见有差别。结论:本地区AsC和CHB患者以感染HBV B基因型为主,C基因型和e抗原阳性是HCC发生的危险因素,同时C基因型可能和肝脏高纤维化程度相关。

Objective：To detection the distributions of different hepatitis B virus（HBV）genotypes in patients with asymptomatic carriers（AsC）,chronic hepatitis B（CHB） and hepatocellular carcinoma（HCC）,and to confirm the different results of clinical laboratory examination and liver fibrosis result from different HBV genotypes infection.Methods：We selected 62 patients with AsC,89 patients with CHB and 86 patients with HCC after HBV infection randomly.HBV genotypes were detected by real-time fluorescence quantitative polymerase chain reaction（FQ-PCR） with two different color dyed Taqman MGB probes.The general information as well as laboratory results of patients were obtained by reviewing of patients′ hospitalized documentation.Statistical software SPSS10.0 was used to analyze these data.Results：Patients with AsC and CHB infected with genotype B are dominant,accounting for 80.65%,78.65%,respectively;But patients with HCC infected with genotype C are dominant,accounting for 70.93%.The infection ratio of C genotypes in HCC group are significant higher than the other groups（P〈0.001）.No obvious different results of clinical laboratory examination between HBV genotype B and C in patients with AsC or CHB were revealed.Patients with genotype C had higher rate of positive HBV e antigen than those with genotype B in patients with HCC（P〈0.05）.The serum HA,LN and PCⅢ concentrations in patients infected C genotype were higher than those infected B genotype in CHB and HCC groups（P〈0.01,P〈0.05 and P〈0.05,respectively）,no obvious difference revealed in AsC group.Conclusion：Patients with AsC and CHB infected with genotype B are dominant.HBV genotype C and positive HBV e antigen are risk factors of HCC.HBV C genotype is probably related to liver cirrhosis.