e抗原阴性的慢性乙型肝炎患者病毒基因变异与临床转归

目的研究HBeAg阴性的慢性乙型肝炎病毒的基因变化及其与临床转归的关系。方法应用基因测序的方法检测HBeAg阴性的慢性乙型肝炎、肝硬化患者乙型肝炎病毒1762、1764、pre-18963个位点的基因突变,分析肝炎、肝硬化的发生与各位点变异的关系。结果135例HBeAg阴性的慢性乙型肝炎患者中发生1762位点变异者9例,pre-1896位点变异者36例,1762、1764位点联合变异者27例,1762、1764、pre-1896位点联合变异者63例。45例肝硬化患者中发生pre-1896位点变异者27例,1762、1764位点联合变异者9例,1762、1764、pre-1896位点联合变异者共9例。结论山东地区HBeAg阴性的慢性乙型肝炎患者乙型肝炎病毒以BCP1762、1764、pre-1896位点联合变异为主,其中pre-1896位点的变异对于肝硬化的发生有重要意义。

Study on gene mutation and clinical prognosis of chronic hepatitis B patients with e antigen-negative

Objective To study gene mutation and clinical prognosis of chronic hepatitis B with e- antigen negative. Methods Gene sequencing was used to detect 3 sites of gene mutation （ 1762, 1764 and pre-1896） of hepatitis B virus in patients with HBeAg-negative chronic hepatitis B or liver cirrhosis. The re- lationship between gene mutation and hepatitis or cirrhosis were analyzed. Results Among 135 chronic hep- atitis B cases with e-antigen negative, there were 9 cases with 1762 mutation, 36 cases with pre-1896 muta- tion, 27 cases with 1762 and 1764 joint variation, and 63 cases with 1762, 1764 and pre-1896 joint varia- tion. However, among 45 liver cirrhosis cases, there were 27 cases with pre-1896 mutation, 9 cases with 1762 and 1764 joint variation, and 9 cases with 1762, 1764 and pre-1896 joint variation. Conclusions Most cases in Shandong province with HBeAg-negative chronic hepatitis B have 1762, 1764 and pre-1896 joint variation, of which pre-1896 mutation is important to liver cirrhosis.