铜陵地区乙型肝炎病毒基因型分布及其与临床的相关性研究

Distribution and clinical correlation research of hepatitis B virus genotypes of patients in Tongling area

目的了解铜陵地区乙型肝炎病毒(HBV)基因型的分布,分析该地区不同基因型别与肝功能损害、病毒复制水平及血清标志物的关系,探讨不同基因型的临床意义。方法采用聚合酶链反应(PCR)-反向点杂交法(RDB)对铜陵地区228例HBV阳性感染者的血清分别进行HBV基因型分型、HBV载量以及乙型肝炎血清标志物和肝功能等的检测,并结合其指标进行相关性分析。结果在228例患者的血清样本中,226例样本成功分型,其中B型54.4%(124/228)、C型37.3%(85/228)、B/C混合型7.5%(17/228),2例未检出,占0.09%。不同HBV基因型患者间年龄、e抗原(HBeAg)、e抗体(抗HBe)、肝功能的差异无统计学意义(P>0.05)。C型HBV载量明显高于B型及B/C混合型(P<0.01)。结论铜陵地区HBV基因型的分布以B型为主,其次为C型和少量B/C混合型;C型感染者HBV载量显著高于B型,C型感染者肝脏损害较B型重,提示HBV基因型可能影响患者体内HBV复制并可能引起不同临床类型的慢性肝病。

Objective To understand the distribution of genotypes in Tongling area,to analyze the relationship of different genotypes with liver function damage,virus replication and serum markers,and to investigate the clinical significance of different genotypes. Methods Polymerase chain reaction（ PCR）-reverse dot blot（ RDB） was used to determine hepatitis B virus（ HBV） genotypes,HBV load,serum markers of hepatitis B and liver function among 228 patients infected with HBV in Tongling area. The correlation analysis was performed with other parameters. Results In228 serum samples,226 samples were successfully genotyped,including 54. 4% B type（ 124 /228）,37. 3% C type（ 85/228） and 7. 5% B/C hybrid type（ 17/228）,and 2 cases（ 0. 09%） were not detected. Differences between different HBV genotypes and age,e antigen（ HBeAg）,anti-e antigen antibody（ anti-HBe） and liver function had no statistical significance（ P 0. 05）. The C type HBV load was significantly higher than those of B type and B /C hubrid type（ P 0. 01）. Conclusions The distribution of HBV genotypes in Tongling area is dominated by B type,followed by C type and a small amount of B /C hybrid type. C type infected patients＇ HBV load is significantly higher than that of B type. The liver damage of patients with C type is more serious than that of B type,which prompts that HBV genotypes may influence on in vivo HBV replication and may cause chronic liver disease of different clinical types.