核苷(酸)类似物治疗显效的慢乙肝患者外周血单个核细胞中HBx基因检测及临床意义

Detection and clinical significance of HBx gene in patients with chronic hepatitis B treated by NAs

目的对采用核苷(酸)类似物(NAs)治疗显效慢乙肝患者外周血单个核细胞中的HBx基因进行检测,并对检测结果展开分析,探究HBx基因的临床意义。方法选取2015年4月~2017年8月天津市第二人民医院采用NAs治疗的显效慢乙肝患者70例作为研究对象,70例患者根据疾病病情分为A、B、C三组,A组为显效慢乙肝患者(23例),B组为乙肝后肝硬化患者(25例),C组为肝细胞性肝癌患者(22例)。对全部患者外周血单个核细胞中的HBx基因展开检测,并对检测结果展开分析。结果本次研究选取的70例显效慢乙肝患者经检测发现外周血单个核细胞中存在HBx基因的患者为43例,即检出率为61.43%,且B、C两组患者外周血单个核细胞中HBx基因的检出率显著高于A组(P<0.05);在A、C两组部分患者中检测发现HBx基因存在热点突变,即A389T/G391A、T380C,且C组患者A389T/G391A热点突变的出现率显著高于A组(P<0.05)。结论在采用NAs治疗的显效慢乙肝患者中,外周血单个核细胞中HBx基因的检出率因病症发展情况的不同而存在一定差异性,其中乙肝后肝硬化及肝细胞性肝癌患者的检出率较高,显效慢乙肝患者及肝细胞性肝癌患者的HBx基因存在热点突变,且后者出现的可能性远高于前者。

Objective To detect the HBx gene in peripheral blood mononuclear cells of patients with chronic hepatitis B treated with NAs therapy, and to analyze the detection results, and to explore the clinical significance of HBx gene.Methods From the second people’s Hospital of Tianjin city from April 2015 to August 2017 by NAs treatment in patients with chronic hepatitis B treatment implemented effective 70 cases as the research object 70 patients according to the severity of the disease is divided into A, B, C three groups, A group was markedly effective in patients with chronic hepatitis B（n = 23）, B group（n =25） in patients with liver cirrhosis after hepatitis B, group C in patients with hepatocellular carcinoma（n = 22）. The HBx gene was detected in peripheral blood mononuclear cells of all patients, and the results were analyzed.Results 70 cases of patients with chronic hepatitis B of this study selected by detection of HBx gene in peripheral blood mononuclear cells of patients with 43 cases, the detection rate was 61.43%. The detection rate of HBx gene and B, C two groups of patients with peripheral blood mononuclear cells were significantly higher than those in A group（P 〈 0.05）; detection found the HBx gene mutations in A,C hot two groups of patients, A389 T/G391 A, T380 C, and C group, patients with A389 T/G391 A hot spot mutation rate was significantly higher than that of group A（ P 〈 0.05）.Conclusion In the use of NAs treatment in patients with chronic hepatitis B treatment implemented effective, HBx gene in peripheral blood mononuclear cells in the detection rate and there exists some differences due to different development conditions, a higher detection rate of patients with liver cirrhosis and one case of hepatocellular carcinoma cases, there was HBx gene in patients with chronic hepatitis B and liver hepatocellular carcinoma cases patients with mutations, and the latter possibility is far higher than the former.