乙型肝炎病毒YMDD变异与基因分型及临床关系的研究

目的了解青岛市乙型肝炎患者乙型肝炎病毒（HBV）基因变异特征,探讨HBV YMDD变异与基因分型、DNA载量及临床分型的关系。方法应用实时荧光聚合酶链反应（PCR）技术对820例乙肝患者血清进行基因变异检测,HBV DNA定量监测及基因分型检测。结果 820例HBV感染者中检出YMDD变异154例,变异率18.78%;各基因型间YMDD变异的差异有统计学意义,P〈0.05;患者HBeAg阳性与否与YMDD变异差异有统计学意义（P〈0.05）,HBeAg阳性者更易发生变异;HBV感染者临床分型各组间YMDD变异的差异有统计学意义（P〈0.05）,其中以LC（36/113）、CHB（97/368）为主;病毒变异在性别、年龄及DNA载量各组间的差异均无统计学意义（P〉0.05）。结论 HBV YMDD变异的监测对乙肝患者的治疗、病情预测和转归都有重要临床意义。

Research of the clinical relationship between hepatitis B virus YMDD variation and genotyping

Objective To investigate hepatitis B virus（HBV） variation features in the patients with hepatitis B in Qingdao,and the relationship of HBV YMDD variation with genotyping,DNA load and clinical classification.Methods The YMDD variation,DNA load and genotyping were determined in 820 patients with hepatitis B by real-time fluorescence quantitative polymerase chain reaction（PCR）.Results The YMDD variations were determined in 154 patients with hepatitis B,and the variation rate was 18.78%.The YMDD variations between the different genotypes were statistically different（P 0.05）.HBeAg positive or not was statistically significant with YMDD variation（P0.05）,and the variation happened more easily in the patients with HBeAg positive.YMDD variation between the different HBV infection clinical classification had statistical significance（P0.05）.The LC（36/113） and CHB（97/368） were the most.The differences between sex,age and DNA load groups were not significant（P0.05）.Conclusions The monitoring of HBV YMDD variation is important to the clinical therapy,prediction and prognosis.