拉米夫定治疗HBV感染患者血清HBV-DNA定量水平与YMDD变异的相关性研究

The correlation study beteen HBV-DNA quantity level and YMDD variation in serum of HBV infection patients treated by lamivudine

目的 观察拉米夫定治疗慢性乙型肝炎（CHB）患者过程中,CHB患者血清HBV-DNA水平与YMDD变异的关系.方法 将服用拉米夫定治疗的慢性乙型肝炎患者按治疗前血清中HBV-DNA水平高低分成两组,低于1.00×105copies/ml为Ⅰ组,高于或等于1.00×105copies/ml为Ⅱ组,对在治疗过程中患者血清中HBV-DNA水平与YMDD变异率及变异类型之间的关系进行比较分析.结果 血清HBV-DNA水平高于或等于1.00×105copies/ml组发生YMDD变异显著高于HBV-DNA水平低于1.00×105copies/ml组（P〈0.01）.YMDD变异类型与血清HBV-DNA定量水平无明显相关性（P〉0.05）.结论 CHB患者血清HBV-DNA水平越高,应用拉米夫定治疗越容易产生YMDD变异,YMDD变异类型与血清HBV-DNA水平无明显相关性.

Objective To observe the relationship between the serum HBVDNA level and the emergence of YMDD motif mutants during the therapy of lamivudine against chronic hepatitis B （CHB） . Methods The CHB patients before lamivudine therapy were divided two groups by the serum HBVDNA level. The serum HBVDNA level was under 1.00 × 10^5 eopies/ml as the first group and the serum HBVDNA level was on 1.00× 10^5 copies/ml as the second group. The relationship between the serum HBVDNA level and the YMDD mutant rates and the YMDD mutant sort were analyzed and compared with during the therapy of lamivudine against CHB. Results The incidence of YMDD motif mutants in the first group , which the serum HBVDNA level was on 1.00 × 10^5 copies/ml, was significantly higher than in the second group（ P 〈 0.01 ） , which the serum HBVDNA level was under 1.00 × 10^5 copies/ml. There is no significant relationship between the YMDD mutant sort and the serum HBVDNA level （P 〉 0.05） . Conclusion The higher the CHB patients serum HBVDNA level is, the easier the YMDD mutant comes into being if lamivudine is administered. There is no significant relationship between the sort of YMDD motif mutant and the serum HBVDNA level.