慢性乙型肝炎乙肝病毒基本核心启动子变异的实验与临床研究

目的 研究乙型肝炎基本核心启动子(BCP)变异与慢性乙型肝炎病情的关系.方法 通过PCR及其产物直接检测128例慢性乙型肝炎(CHB)患者HBV,同时检测患者HBV定量及血清生化指标.结果 128例标本中nt1762、1764变异(双变异)共检出56例,nt1753、1762、1764变异(三变异)共检出10例,肝炎肝硬化(LC)组中双变异明显高于其他CHB组(P＜0.05);双变异组的HBeAg、ALB明显低于无变异组(P＜0.05),三变异组HBeAg明显低于双变异组(P＜0.05).结论 BCP区双变异可减少HBeAg的表达,引起肝功能受损严重并导致肝硬化的发生,BCP区尚有新发现的变异如三变异也可影响HBeAg的表达.

Experimental and clinical study on hepatitis B virus basic core promoter mutations in patients with chronic hepatitis B

Objective To study the significance of hepatitis B virus(HBV) basic core promoter(BCP) mutations in patients with chronic hepatitis B.Methods BCP gene was sequenced directly from 128 patients with chronic hepatitis B.After amplification by PCR the level of HBV and serum biochemical indices were determined.Results Serum samples of 56 patients were detected with nt1762 and 1764 mutation,and the samples of 10 patients were detected with nt1753,1762 and 1764 mutation.nt1762 and 1764 mutation in the patients with hepatitis and chirosis(LC) was higher than that in those with chronic hepatitis(CHB)(P<0.05),the level of HBeAg and ALB in patients with nt1762 and 1764 mutation was less than that without any mutations(P<0.05) and the level of HBeAg in patients with nt1753,1762 and 1764 mutation was less than that with nt1762 and 1764 mutation(P<0.05).Conclusion nt1762 and 1764 mutation in BCP can reduce the level of HBeAg,result in severe liver damage and make it easier to turn to LC.The new detected mutation like nt1753,1762 and 1764 mutation also can affect the level of HBV.