【摘要】 目的研究楚雄地区乙型肝炎病毒(HBV)基因分布特征及基因耐药情况,有利于临床合理抗病毒治疗及治疗预后评估。方法采用荧光定量PCR和基因芯片方向斑点技术检测乙型肝炎患者血清中DNA水平、基因分型及耐药性。结果对103例乙型肝炎患者进行检测,未检测出乙型肝炎DNA水平18例,检测出DNA水平85例。对85例基因分型:C型63例,占74.1%;B型21例,占24.7%;B、C混合型1例,占1.2%。检出野生型基因位点57例,占67%;检出突变型基因位点28例,占33%。基因突变位点rt180M(17例),rt204V(12例),rt204I(6例),rt207I(3例),rt181V(3例),rt236T(3例)。拉米夫定5例敏感,23例耐药;替比夫定22例敏感,6例耐药;阿德福韦酯24例敏感,4例耐药;恩替卡韦敏11例敏感,17例可能产生耐药。结论该地区乙型肝炎分型主要以C型为主,基因突变位点主要以rT180M为主,其次是rT204V。抗病毒治疗药物拉米夫定耐药最常见,替比夫定及阿德福韦酯最敏感,恩替卡韦居中。更多还原

【Abstract】 Objective To investigate the distribution characteristics of hepatitis B virusgene types and the situation of drug resistance gene in Chuxiong area and to benefit the rational clinical antiviral therapy and the prognostic evaluation.Methods The DNA content,hepatitis B virus gene types and drug resistance associated sites in serum of hepatitis B patients were detected by the technology of fluorescence quantitative PCR and the gene chip of reverse dot blot.Results Among 103 serum samples,detection of DNA content in 85 samples was positive while DNA content of 18 samples was negative.85 positive samples were typed for hepatitis B virus DNA,of which 63 samples were classified as type C(74.1%),21 samples were classified as type B(24.7%)and 1sample was classified as mixed type B and C(1.2%).57 samples had the wild-type gene loci(67%)and 28 samples had the mutant gene locus(33%).Among these samples,17 cases of mutation were placed in rt180 M,12cases were placed in rt204 V,6cases were placed in rt204 I,3cases were placed in rt207 I,3cases were placed in rt181 Vand 3cases were placed in rt236 T.Among 28 samples of drug resistance gene mutation,5,22,24 and 11samples were sensitive to lamivudine,telbivudine,adefovir and Entecavi,respectively.Conclusion The main hepatitis B virus genotype is type C in Chuxiong area.The most important mutant site is rt180 Mand the second is rt204 V.The most sensitive drugs are telbivudine and adefovir in clinical antiviral therapy and the second sensitive drug is Entecavi While the most commonly resistant drug is lamivudine.更多还原