胸腺肽治疗及病毒定量与人乙型肝炎病毒酪氨酸-蛋氨酸-天冬氨酸-天冬氨酸基序变异发生的关系

Relationship between HBV YMDD mutant and treatment with thymosin-a or baseline viral quantitation

目的 分析胸腺肽干预及病毒定量与酪氨酸蛋氨酸天冬氨酸天冬氨酸基序 (YMDD)变异发生的关系。方法 4 4例患者来自我科一项临床试验 ,采用聚合酶链反应限制性片段长度多态性 (PCR RFLP)法检测YMDD变异 ,观察两个因素与变异发生的关系。结果 联用组与单用组比较 ,变异发生率无明显差异 (2 5 %vs8.33% ) ,P >0 .0 5。基线病毒定量高者与低者耐药率亦差异无统计学意义 (15 .4 %vs 16 .1% ) ,P >0 .0 5。结论 初步结果提示 ,与单用拉米夫定比较 ,胸腺肽联合拉米夫定治疗乙型肝炎病毒 (HBV)并不能减少YMDD变异发生 ;YMDD变异发生与基线病毒定量水平无关。

Objective To analyze the relationship between HBV tyrosine methionine aspartate aspartate(YMDD) mutant and treatment with thymosin a or baseline viral quantitation.Methods Forty four patients belong to a cohort of patients who were included in a clinical trial were studied.All these patients′ serums were collected and YMDD mutant was tested by mis matched PCR RFLP,then the relationship was observed among some factors.Results The drug resistant rate in patients with baseline high HBV DNA level and low HBV DNA level is of no statistical difference( 15.4% vs 16.1% ),P> 0.05 .There is no significant difference of YMDD mutant incidence between the combination therapy group and monotherapy group(25% vs 8.33% ),P> 0.05 .Conclusion The priliminary result shows that combination therapy (thymosin a plus lamivudine) can not reduce the risk of lamivudine resistance.The baseline HBV DNA level can not be an efficient factor predicting the emergence of YMDD mutant.