拉米夫定治疗后乙肝病毒耐药基因突变检测及其临床意义

目的 检测服用拉米夫定治疗后乙型肝炎病毒发生基因突变的情况,分析其临床意义.方法 选取2009年1月～2011年6月在某院收治的128例乙型肝炎患者,随机均分为观察组和对照组,观察组患者给予拉米夫定治疗,对照组给予除拉米夫定以外的其他综合治疗,应用实时荧光定量聚合酶链反应(FQ-PCR)检测所有研究对象的乙型肝炎病毒(HBV-DNA)耐药基因180位点和204位点突变的情况.结果 观察组患者基因突变各模式的阳性率均高于对照组,比较差异有统计学意义(P＜0.05).观察组患者基因突变阳性率与服药时间成正比,用药时间越长发生突变阳性率越高(P＜0.05).结论 长时间服用拉米夫定可引起乙型肝炎病毒发生基因突变,而且基因突变阳性率与服药时间成正比,用药时间越长发生突变阳性率越高.通过YMDD变异株的检测,可为临床诊治提供依据,指导临床正确用药.

The resistant gene mutations detection and the clinical significance after lamivudine treatment for hepatitis B virus

OBJECTIVE To test the resistant gene mutations after lamivudine treatment for hepatitis B virus and analyse the clinical significance.METHODS From January 2009 to June 2011,128 cases of patients with hepatitis B were randomly divided into the observation group and control group,the observation group was given lamivudine treatment,the control group was given comprehensive treatment except lamivudine treatment.Then the resistant gene mutations of HBV-DNA 180 sites and 204 sites were tested by the real-time fluorescence quantitative polymerase chain reaction(FQ-PCR)testing.RESULTS The positive rates of each gene mutations mode of the observation group were higher than those of the control group,the comparing differences were statistical significance(P﹤0.05).The genetic mutations of observation group were proportional to the medicine time.The more medicine time had,the mutations were higher(P﹤0.05).CONCLUSION The longtime taking Lamivudine can cause hepatitis B virus gene mutations,and positive rate of genetic mutations is proportional to the medication time,the more medicine time has,the mutations are higher.The YMDD mutant detection can provide the basis for clinical diagnosis and treatment,and clinical guidance for correcting drug use.