摘要
目的:探讨山东地区HBV基因型在不同病情感染者之间的分布和基因型与干扰素治疗应答的关系。方法:随机选择249例慢性HBV感染者,用巢式PCR进行A-F基因型别分析,对其中126例慢性乙型肝炎患者采用α干扰素治疗,300万u/次,肌肉注射,3次/周,疗程6个月,所有患者均在治疗前、治疗期间及治疗后检测肝功能、HBV血清学指标及HBV DNA。结果:249例中无症状携带者53例,慢性肝炎126例,肝硬化38例,重型肝炎32例。在A-F基因分型中,无症状携带者组以B基因型为主28/53(52.8%),而C基因型则在活动性肝病中占优势:慢性肝炎69/126(54.8%);肝硬化20/38(52.6%);重型肝炎17/32(53.1%),差异有统计学意义(P<0.05)。在慢性肝炎组中,B基因型组HBV DNA定量及ALT水平均较C基因型组和B+C基因型组为低,差异有统计学意义(P<0.01)。不同基因型组间,年龄、性别差异无统计学意义(P>0.05)。126例慢性乙型肝炎患者用α干扰素治疗6个月,完全应答率:B型19/38(50%),C型9/69(13%),B+C型5/19(26.3%),与B基因型和B+C基因型相比,C基因型对干扰素抗病毒治疗应答率显著低(P<0.05)。结论:山东地区HBV C基因型在活动性肝病中占优势;HBV C基因型对α干扰素抗病毒治疗的完全应答率较低。
Objective To research HBV genotypes in different clinical HBV infections and its response to interferon treatment in Shandong province. Methods Two hundred and forty-nine cases of chronic HBV infection were randomly selected and tested by nested PCR analysis of HBV genotypes A-F, in which 126 cases of chronic hepatitis B patients were treated with interferon-α, 3 million U, intramuscularly, 3 times / week, for 6 months. All the patients were tested liver enzymes, serum HBV marker and HBV DNA during the treatment. Results In the 249 cases, 53 were asymptomatic carriers（asymptomatic carriers group）, 126 chronic hepatitis B（chronic hepatitis group）, 38 liver cirrhosis（liver cirrhosis group）, and 32 severe hepatitis （severe hepatitis group）. In asymtomatic carriers group, B genotype was of majority, 28/53 （52. 8%）; C genotype was 69/126 （54. 8%） in group, 20/38（52. 6%）in liver cirrhosis group and 17/32（53. 1%） in severe hepatitis group. HBV genotypes distribution in different infections showed a significant difference （P〈0. 05）. In chronic hepatitis group, the complete response was 19/38（50%）of B genotype, 9/69（13%） of C genotype, and 5/19（26.3%）of B＋Cgenotype. Compared with Bgenotype and B＋Cgenotype, the response to interferon treatment was lower in C genotype （P 〈0. 05）. Conclusion In Shandong province, C genotype of HBV is of majority in chronic hepatitis B, liver cirrhosis and severe hepatitis, and the response to interferon-α treatment is low.
出处
《中华实用诊断与治疗杂志》
2008年第9期647-649,共3页
Journal of Chinese Practical Diagnosis and Therapy
关键词
乙型肝炎
临床
HBV基因分型
干扰素
Hepatitis B
clinic
the genotype of hepatitis B virus
α interferon
