慢性丙型肝炎患者血清基因型与HCVRNA的相关性研究

Correlation between genotype and HCV RNA in chronic hepatitis C patients

目的研究丙型肝炎患者HCV基因型的分布，探讨基因型在性别上的分布以及基因型与HCVRNA病毒载量的相关性。方法收集2010年5—12月来自40家医院的206例丙型肝炎患者的血清标本，采用瑞士罗氏公司生产的定量PCR试剂（罗氏试剂）对进行HCVRNA检测，应用雅培公司生产的Abbott RealTime HCV Genotype11试剂（雅培试剂）对206例丙型肝炎患者的血清标本进行基因分型，分析基因型在性别上的分布以及HCV基因型与HCVRNA病毒载量的相关性。结果206份HCVRNA阳性血清标本中HCV1型（未具体分1a和1b型）占3．4％（7／206）、1a型占1．0％（2／206）、1b型占59．7％（123／206）、2型占15．5％（32／206）、3型占13．1％（27／206）、6型占2．9％（6／206）、1／6混合型占2．4％（5／206）、2／4混合型占0．5％（1／206），未分型占1．5％（3／206）。132例基因1型和65例非基因1型（2型、3型和6型）患者HCV基因型在性别上的分布差异无统计学意义（z。=0．000，P〉0．05）。188例患者不同基因型之间血清HCVRNA病毒载量差异有统计学意义（F=3．371，P〈0．05）。将197例HCV单基因型患者按地区分为东、南、西、北、中5组，基因型1型与非基因1型在地区分布上差异无统计学意义（χ2=5．840，P〉0．05）。结论丙型肝炎病毒感染以1b型为主，其次为基因2型。基因型在性别上的分布没有差异。基因1b型HCVRNA病毒载量高于基因3型，基因2型HCVRNA病毒载量高于基因3型，基因6型HCVRNA病毒载量高于基因3型。

Objective To determine the distribution of HCV genotypes in patients with chronic hepatitis C, study the distribution of genotype in different gender and the relationship between genotypes and serum HCV-RNA levels. Methods Two hundred and six cases of HCV RNA positive patients （ all with relevant clinical data） receiving pegylated interferon therapy were collected from May to December 2010. HCV RNA was detected in 206 hepatitis C patients from 40 hospitals in China by Roche ＂ Cobas AmpliPrep/Cobas TaqMan HBV test＂, and genotype was determined by ＂Abbott RealTime HCV Genotype II＂. The distribution of genotypes in the gender was analyzed by chi-square test analysis. The relationship between genotypes and serum HCV RNA levels was detected by single factor analysis and two independent sample t test analysis. Results There were seven different subtypes of HCV in 206 samples, including genotype 1,7 cases （3.4% ,7/206） ; genotype la, 2 cases （ 1.0%, 2/206 ） ; genotype lb, 123 cases （59. 7%, 123/206） ; genotype 2, 32 cases （ 15.5%, 32/206 ） ; genotype 3,27 cases （ 13. 1%, 27/206） ; genotype 6,6 cases （2. 9% ,6/206） ;genotype 1/6,5 cases （2.4% ,5/206） ;genotype 2/4,1 cases （0. 5% , 1/206）. There was no significant difference between HCV genotype and gender in 132 cases with genotype 1 and 65 cases with non-genotype 1 （ genotype 2,3,6 ） （X2 = 0. 000, P 〉 0. 05 ）. There was significant association between quantity of HCV RNA and genotype in 188 patients with HCV （F = 3. 371,P 〈 0. 01 ）. The 197 patients with HCV single genotype were divided into five groups in terms of region （East, South, West, North and Center）. There was no significant difference between HCV genotype 1 and non-genotype 1 in the five groups （χ2 = 5. 840, P 〉 0.05）. Conclusions It is suggested that HCV 1 b is the most prevalent type in China, followed by HCV 2. There is no significant difference between HCV genotype and gender. The levels of HCV RNA with genotype lb are significantly higher than those with genotype 3. The levels of HCV RNA with genotype 2 are significantly higher than those with genotype 3. The levels of HCV RNA with genotype 6 are significantly higher than those with genotype 3.