型特异性引物PCR研究HBV基因型与临床表现的关系

Relation between genotype of HBV and its clinical manifestation by PCR with genotype-specific primers

目的 :研究乙肝病毒 (HBV)基因型与临床表现的关系。方法 :收集湖南省慢性携带、慢性轻度、慢性中度、慢性重度和慢性重型等 5种临床类型的慢性乙肝病人的血清 2 2 0例 ,采用型特异性引物进行巢式PCR ,对血清中的HBV进行基因分型 ,比较不同基因型的临床资料。结果 :发现B ,C两种基因型 ,比例分别为 86 .4 %和 13.6 %。随着病情加重 ,基因C型的比例增加 (P <0 .0 5 )。C型的谷丙转氨酶 (ALT)、总胆红素 (TBIL)、HBV DNA等平均水平均较B型高 ,但无统计学意义。C型的ALT升高率 (96 .7% )显著高于B型 (75 .2 % ) (P <0 .0 5 )。B ,C两型的HBeAg阳性率总体无差别 ,但在慢性重型以及 2 130岁年龄段的患者中 ,C型的HBeAg阳性率 (35 .0 %和 5 0 .0 % )均显著高于B型 (14 .4 %和 2 4 .5 % ) (均P <0 .0 5 )。结论 :湖南省HBV基因型以B ,C型为主 ,基因型与临床表现有相关性 。

Objective To determine the relation between genotype of HBV and its clinical manifestation.Methods Sera of 220 patients from Hunan Province of China, infected chronically with asymptomatic, mild, moderate, severe and fulminant hepatitis hepatitis B, were genotyped by PCR with genotype-specific primers. The results were statistically analyzed. Results Only genotype B (86.4%) and C (13.6%) were found. With the aggravations of patients′ condition, genotype C was found more often (P<0.05).The levels of alanine aminotransferase (ALT), total bilirubin (TBIL) and HBV-DNA of genotype C was higher than those of genotype B, but there was no statistical difference.However, the ALT elevation rates of genotype C (96.7%) were significantly higher than those of genotype B (75.2%) (P< 0.05). There was no statistical difference in HBeAg rate between genotype B and C in general, but in patients with chronic fulminant hepatitis or aged 21~30, the HBeAg rates of genotype C (35.0% and 50.0%) were significantly higher than those of genotype B (14.4% and 24.5%) (P<0.05). Conclusion The dominant genotype of HBV in Hunan Province of China is genotype B and C. Genotype of HBV correlates with its clinical manifestation and genotype C of HBV can lead to more severe hepatitis than genotype B of HBV.