【摘要】 目的探讨HBV前C区(PreC)及基本核心启动子(BCP)突变与慢性乙型肝炎病毒(HBV)感染者疾病进展的关系。方法收集88例慢性HBV感染者血清标本,包括36例无症状携带者(其中24例为HBV携带者,12例为HBsAg携带者)、36例慢性乙型肝炎(慢性乙肝)和16例肝硬化患者。所有标本均经型特异性引物PCR法鉴定为HBV C基因型,并用巢氏PCR法扩增HBV PreC和BCP基因片段,用PCR产物直接测序法测序,然后用Clustal W1.8软件进行序列分析。结果在50例HBeAg阳性患者中,无症状携带者、慢性乙肝和肝硬化组的T1762/A1764双突变率和T1846突变率分别为12.5%、42.1%、100%和0%、5.3%、28.6%,差异均有统计学意义(P值分别为0.03和0.02)。在38例HBeAg阴性HBV感染者中,无症状携带者、慢性乙肝和肝硬化组的T1762/A1764双突变率分别为16.7%、58.8%和66.7%,差异无统计学意义(P=0.08)。肝硬化组的C/G1753突变率显著高于无症状携带者及慢性乙肝组(分别为55.6%、8.3%、11.8%,P=0.01),其A1896突变率也高于无症状携带者组(分别为55.6%、8.3%,P=0.01)。结论HBV T1762/A1764双突变与C基因型HBV慢性感染者的疾病进展有关。更多还原

【Abstract】 Objective To investigate the association between HBV precore(PreC)/besal core promoter (BCP)mutations with the progress of liver disease in patients with chronic HBV infection.Methods Eighty-eitht patients with genotype C HBV infection were enrolled,including 36 asymptomatic carriers,36 chronic hepatitis and 16 cirrhosis patients.Genotypes were determined by a type-specific primer PCR.PreC/BCP regions of HBV were amplified by nested PCR and sequenced directly.Mutations in PreC/BCP regions were determined by alignment of all sequence using software of Clnstal W1.8.Results In 50 HBeAg-positive patients,frequencies of T1762/ A1764 and T1846 mutations in groups of asymptomatic carriers,chronic hepatitis B and liver cirrhosis were 12.5%,42.1% and 100%,0%,5.3% and 28.6%,respectively,with significant differences among these three groups(P=0.03 and P=0.02,respectively).Among 38 HBeAg-negative patients,T1762/A1764 muta- tion frequencies of asymptomatic carriers,patients with chronic hepatitis B and liver cirrhosis were 16.7%, 58.8% and 66.7%,respectively(P=0.08).The group of patients with liver cirrhosis had a significantly higher frequency of C/G1753 mutation than that of asymptomatie carrier and chronic hepatitis B groups(55.6% vs 8.3% and 55.6% vs 11.8%,P=0.01 ).The frequency of A1896 mutation in the liver cirrhosis group was also signifi- cantly higher than that of the asymptomatie carrier group(8.3% vs 55.6%,P=0.O l ).Conclusion T1762/ A1764 mutations may be associated with progression of the genotype C HBV related liver disease.更多还原