拉米夫定耐药与HBV YMDD变异关系的研究

Research on relationship of HBV YMDD mutation and lamivudine resistance.

探讨拉米夫定耐药与HBVYMDD变异之间关系。对拉米夫定治疗的慢性乙型肝炎进行肝功能、乙肝病毒血清学指标、YMDD耐药基因变异检测。 10 2例慢性乙型肝炎血清中 ,HBVDNA阴性 6 3例 (6 1 8% ) ,39例阳性 ,其中HBVYMDD变异 2 2例 ,变异率为 5 6 4 % ,并与用药时间长短有关 ,9- 17个月和 18- 30个月变异检出率分别为5 1 7%和 70 % ,HBVYMDD变异组ALT为 (5 9 94± 8 6 0 )U/L ,显著高于无HBVYMDD变异组的 (5 0 6 0± 6 12 )U/L。基因芯片技术检测HBVYMDD变异有一定的临床意义 ,YMDD变异是HBV对拉米夫定耐药的原因之一。

To detect YMDD mutations of HBV by gene chips in patient with chronic hepatitis B treated with lamivudine and to evaluate its clinic importance. Sera of 102 patients with chronic hepatitis B treated with lamivudine 9-30 months were detected for ALT、HBV makers、YMDD mutation. In 102 patients, HBV DNA turned negative in 63 cases (61.8%), 22 cases of YMDD mutations among 39 patients (56.4%),its rate increasing with length of lamivudine treatment as rate was 51.7% between 9-17 months and rate 70% between 18-30 months. ALT level in patients with YMDD mutation was significant higher than the groups without YMDD mutation(59.94±8.60)U/L vs (50.60±6.12)U/L,P<0.05. Gene chips can be applied to identifying HBV YMDD mutant clinically; YMDD mutation is one of the reason that HBV resistant to lamivudine and may lead to elevation of ALT.