【摘要】 目的探讨无锡地区慢性乙型重型肝炎HBV基因型和核苷酸多态性分布的特点。方法套式PCR扩增HBVDNAS基因后作序列分析。结果50例慢性乙型重型肝炎患者B基因型1例(2%),C基因型43例(86%),BC混合基因型6例(12%);各基因型死亡率无显著差异,P>0.05。B、BC混合基因型S基因第139位、140位、146位、167位、170位、176位、191位、248位、254位、328位、337位、377位核苷酸与C基因型S基因第145位、157位、203位核苷酸各有聚集性改变,其中139与140位、145与146位有联合改变,并导致相应氨基酸的置换。结论无锡地区慢性乙型重型肝炎多见于C、BC混合基因型,C、B、BC基因型核苷酸呈多态性改变。更多还原

【Abstract】 Objective To explore the features of genotypes and nucleotide polymorphisms in the patients with severe chronic hepatitis B in Wuxi region.Methods HBV DNA was amplified by nested polymerase chain reaction,and S gene fragment was detected by direct sequencing.Results The results of genotyping showed that among 50 patients with severe chronic hepatitis B 1 case (2%) was genotype B,43 cases(86%) were genotype C,6 cases(12%) were mixed genotypes (B and C).The mortality of genotype C and mixed genotypes were 39.5%(17/43) and 50%(3/6) respectively.There was no significant difference between genotype B/mixed B,C genotypes and genotype C for mortality (χ~2=0.21,P>0.05). The assembling mutation in S gene,which caused amino acid substitutions,occurred at the nucleotide site 139,140,146,167,170,176,191,248,254,328,337 and 377 in genotype B and mixed genotype B and C,and at nucleotide site 145,157 and 203 in genotype C.The mutations of points 139/140 and 145/146 were bound together.The variations of nucleotides between genotype B/B,C and genotype C were different.Conclusions The results suggest that the patients with severe chronic hepatitis B may related to both genotype C and mixed genotypes B and C,and all the three genotypes presented nucleotide polymorphisms.更多还原