两种检测乙型肝炎病毒YMDD变异方法的临床应用

Clinical application of two methods detecting YMDD mutation of hepatitis B virus

目的比较两种检测HBV YMDD变异方法的应用价值。方法采用PCR-荧光探针法和DNA测序法检测54例HBV感染者HBV YMDD变异情况,并比较两种方法的应用价值进行分析。结果 PCR-荧光探针法检测出YMDD野生型34例和YMDD突变型20例;其中,YMDD突变型包括YIDD突变型、YVDD突变型和YIDD+YVDD突变型。DNA测序法检测出YMDD野生型15例和YMDD突变型39例;其中,YMDD突变型除了YIDD突变型、YVDD突变型和YIDD+YVDD突变型,还伴有L180M+M204V、L80I+M204I等位点的突变。PCR-荧光探针法的阳性检出率为37.04%,低于DNA测序法的72.22%(P<0.05)。以DNA测序结果为相对标准,PCR-荧光探针法检测HBV YMDD变异的相对灵敏度为51.28%,符合率为64.81%。结论与PCR-荧光探针法比较,DNA测序法检测HBV YMDD变异具有较高的检出率和符合率,更适用于临床。

Objective To compare the value of two methods detecting YMDD mutation of hepatitis B virus（HBV）.Methods The variation of HBV YMDD of 54 patients infected with HBV was detected by PCR fluorescent probe method and DNA sequencing.The application value of two methods was compared.Results According to PCR fluorescent probe method,YMDD wild type was detected in 34 cases and YMDD mutant type was detected in 20 cases.YMDD mutant type included YIDD mutant,YVDD mutant and YIDD＋YVDD mutant.According to DNA sequencing,YMDD wild type was detected in 15 cases and YMDD mutant type was detected in 39 cases.YMDD mutant type included L180 M ＋ M204 V mutant,L80 I＋ M204 Imutant and others except YIDD mutant,YVDD mutant and YIDD＋YVDD mutant.The positive rate detected by PCR fluorescent probe method was lower than that by DNA sequencing（37.04% vs.72.22%）（P〈0.05）.According to the relative standard of DNA sequencing in detecting HBV variation,the sensitivity of PCR fluorescent probe method was 51.28% and the coincidence rate was 64.81%.Conclusion Compared with PCR fluorescent probe method,DNA sequencing detecting YMDD HBV mutation has higher positive rate and coincidence rate,which is more suitable for clinical use.