摘要
目的探讨乙型肝炎病毒(HBV)前C区1896位点突变株感染的临床特点及其对干扰素治疗的反应差异。方法采用PCR法检测HBV感染者HBV前C区1896点突变,同时检测HBV M和血生化指标。结果HBV前C区1896位点突变株感染病人和野生株感染病人ALT水平分别为268.42±243.76U/L和186.78±142.75U/L,AST为279.66±241.11U/L和172.33±157.27U/L,SB为164.36±114.28μmol/L和82.83±64.39μmol/L,ALB为36.04±5.36g/L和43.27±6.17g/L(P<0.05);HBeAb阳性者和HBeAg阳性者中突变株感染占77.2%和11.3%(P<0.05);慢性重型肝炎组、肝硬化组突变株检出率分别为68.57%和44.23%,明显高于慢性肝炎轻中度组和慢性乙型肝炎重度组的25.47%和40.29%(P<0.01)。HBeAg阳性组和HBeAb阳性组突变株感染对干扰素治疗应答率分别为28.6%和20.8%,明显低于野生株感染者的44.0%和37.5%(P<0.05)。结论HBV前C区1896位点突变株感染普遍存在,突变株感染者病情较重,对干扰素治疗应答率低。
Objective To elucidate the clinical feature and therapeutic response to IFN in patients with HBV precore mutant （1896 G→A point mutation） infection. Methods Mutation specific PCR was employed for detecting precore mutation from 260 cases,meanwhile,we detected HBV marker and serum ALT,AST,SB and ALB levels. Results The levels of ALT in patients with precore mutation and in patients with wild type infection were 268.42±243.76U/L and 186.78±142.75U/L,AST were 279.66±241.11U/L and 172.33±157.27U/L,SB were 164.36±114.28μmol/L and 82.83±64.39μmol/ L,ALB were 36.04±5.36g/L and 43.27±6.17g/L （P〈0.05）;The rate of precore mutation infection in HBeAb＋ group was 77.2%（51/66） and in HBeAg＋ group was 11.3%（18/159,P〈0.05）. The rates of precore mutation infection in chronic severe hepatitis and cirrhosis （68.57% and 44.23%） were higher than in other groups （47% and 40.29%）（P〈0.01）. The therapeutic response rates to IFN in precore mutation infection groups were lower than those in wild type groups（P〈0.01）. Conclusion Point mutation in site 1896 of HBV precore mutant infection exists in patients with chronic Hepatitis B. The patients with precore mutant infection was more severe.
出处
《实用肝脏病杂志》
CAS
2008年第6期364-365,375,共3页
Journal of Practical Hepatology
