拉米夫定治疗后乙肝病毒发生YMDD变异的研究

目的 观察拉米夫定治疗后乙肝病毒发生YMDD变异情况。方法 87例慢性乙肝患者分成两组，一组51例接受拉米夫定及保肝治疗，另一组36例做为对照组只给予保肝治疗，治疗1年后对患者HBV多聚酶基因YMDD基序进行定性检测，观察是否有突变。结果 拉米夫定治疗组在用药1年后有8例发生YMDD突变，其中YIDD变异有5例，YVDD变异3例，变异株中有5例伴HBV DNA、ALT水平升高，而对照组无变异株产生。结论 拉米夫定可诱导HBV多聚酶基因(P基因)YMDD基序发生基因突变，而导致耐药株的产生。

YMDD mutation of HBV after treatment with Lamivudine

Objective To investigate YMDD mutation of HBV after treatment with Lamivudine.Methods Eighty seven patients with chronic hepatitis B were divided into two groups.One group (with 51 patients) was treated with Lamivudine and liver protecting drugs,the other (with 36 patients) was treated only with liver protecting drugs.YMDD mutation was analyzed after 1 year.Serum HBV DNA and ALT levels were also detected.Results Eight cases of YMDD mutation were found in the group treated with Lamivudine,and no YMDD mutation in the other group.Conclusion Lamivudine can lead to YMDD mutation in HBV polymerase gene,resulting in resistant strains.