20岁以下免疫耐受期慢性乙肝YMDD自然变异的流行病学调查

Epidemiological Survey for Spontaneous HBV YMDD Motif Mutation of CHB Patients whom under 20 Years Old and in Immune Tolerant Phase

目的探讨20岁（含20岁,下同）以下免疫耐受期慢性乙肝患者YMDD自然变异的发生情况及影响其变异的因素。方法筛选110例20岁以下处于免疫耐受期且从未接受过抗病毒治疗的慢性乙肝（chronic hepatitis B,CHB）患者,检测其YMDD变异情况。结果 110例患者检测出YMDD变异31例（28.18%）,其中YIDD阳性9例、YVDD阳性6例,YIDD和YVDD同时阳性16例。患者性别、年龄、HBeAg状态、血清HBV DNA水平及丙氨酸氨基转移酶（ALT）水平对YMDD自然变异检出率无显著影响（P〉0.05）。结论 20岁以下处于免疫耐受期的CHB患者存在YMDD自然变异,其自然变异的发生率与患者性别、HBeAg水平、血清HBVDNA水平及丙氨酸氨基转移酶（ALT）水平无明显相关。

Objective To investigate the spontaneous mutation rate of HBV YMDD motif and its related factors of CHB patients whom under 20 years old and in immune tolerant phase .Methods To filtrate 110 CHB cases whom under 20 years old and in immune tolerant phase,at the same time these cases do not be treated by any antivirus drugs, then check it YMDD mutations. Rusults Among 110 cases with CHB, spontaneous YMDD variants were detected in 31 cases（YIDD , YVDD and YIDD/YVDD for 9 , 6and 16 cases, respectively）.Gender , age , HBeAg status , serum HBV DNA levels and alanine aminotransferase （ALT）levels were not found to be significantly related with spontaneous YMDD mutation.Conclusions Spontaneous YMDD variants exist in patients with CHB （whom under 20 years old and in immune tolerant phase） , and are unrelated with gender , age , HBeAg status , serum viral levels or ALT levels.