不同肝病患者乙型肝炎病毒BCP/PC区变异研究

Studies of the mutations in the BCP / PC region of hepatitis B virus in patients with different hepatitis

目的探讨不同肝病患者乙型肝炎病毒BCP/PC区突变情况。方法选择乙型肝炎患者245例,其中慢性乙型肝炎(CHB)98例、慢性重症肝炎(CSHB)68例、肝硬化(LC)34例及肝癌(HCC)45例,荧光定量PCR测定其基因型,巢氏PCR扩增BCP/PC区基因,分析其在各个肝病组中的分布情况以及与基因型和HBeAg的关系。结果在所检测的245例患者血清中,检测出变异株134例,占54.7%;CSHB组、HCC组和LC组在A1762T/G1764A、G1896A以及联合变异中,其变异频率明显高于CHB组,差异有统计学意义(P<0.01)。CSHB组和LC组比较差异无统计学意义(P>0.05)。C基因型明显高于B型和B+C型的HBV BCP区变异频率,三者比较差异具有统计学意义(P<0.05)。HBeAg阴性组变异率明显高于HBeAg阳性组,差异有统计学意义(P<0.05)。结论 HBV BCP/PC变异中,CSHB组、HCC组和LC组变异频率明显高于CHB组,HBV BCP/PC变异是导致HBeAg阴性的主要机制之一。

Objective To study the mutations in the basal core promoter（ BCP） and precore（ PC） regions of hepatitis B virus（ HBV） in different liver diseases. Methods 245 HBV-infected patients were collected,including 98 of CHB,68 of CSHB,34 of LC and 45 of HCC,for the detection of genotypes with quantitative fluorescent PCR,and the BCP / PR region was performed by nested PCR amplification. The distribution,genotypes and the correlation with HBeAg were analyzed in different liver-disease groups. Results 134 cases of mutations were detected from 245 serum samples,accounting for 54. 7%. The mutation rates of A1762 T / G1764 A,G1896A and the combined mutations in CSHB,HCC,and LC groups were significantly higher than those in CHB groups,and the differences were statistically significant（ P〈0. 01）. The difference between CSHB group and LC group was not statistically significant（ P〈0. 05）. The mutation rates of genotype C infection were significantly higher than those of the B and B ＋ C,and differences were statistically significant among three of them（ P〈0. 01）. Moreover,the mutation rates of HBeAg negative group was significantly higher than that of the positive group,and the difference was statistically significant（ P〈0. 05）. Conclusion The mutation rates of HBV BCP / PC in CSHB,HCC,and LC groups are significantly higher than those in CHB groups. The mutations of HBV BCP / PC may be associated with the mechanism of negative HBeAg.