西安市乙肝患者HBV基因型分布及临床相关性指标的研究

目的 研究了解西安市乙型肝炎病毒(HBV)的基因型分布及其与临床相关性指标丙氨酸氨基转移酶(ALT)和天门冬氨酸转氨酶(AST)关系和临床意义。方法 采用巢式PCR对389例西安市HBV感染患者的血清标本进行HBV DNA扩增,后用聚合酶链反应-限制性片段长度多态性法(PCR-RLFP)鉴定HBV基因型。并用酶联免疫吸附试验(ELISA)检测乙肝五项,速率法检测ALT和AST。结果 西安市389例HBV感染患者基因型分布为HBV B基因型58例占14.9%(58/389),HBV C基因型326例占83.8%(326/389),HBV B/C混合型5例占1.2%(5/389)。其中HBV B、C基因型与患者在性别和乙型肝炎e抗原(HBeAg)阳性率、HBV DNA载量水平及ALT和AST比较差异均无统计学意义(P0.05);B、C基因型患者在HBV携带者和慢性乙肝中分布比较差异无统计学意义(P0.05),但在肝硬化和肝癌中比较差异有统计学意义(P0.05)。HBV C基因型较B基因型更易发展成为肝硬化甚至肝癌。结论 西安市HBV感染者存在HBV B、HBV C、HBV B/C混合型3种基因型,以HBV C为主要基因型,B型次之,B/C混合型最少;肝硬化的发生与C型存在着一定关系,提示HBV C基因型更容易发展成为肝硬化。

Study on HBV genotype distribution and clinical correlative indexes in patients with hepatitis B in Xi'an

Objective To study the relationship and clinical significance of hepatitis B genotype distribution in Xi'an City and clinical relative indicators.Methods The nested PCR was used to amplify HBV DNA in 389 serum samples from HBV infected pa-tients in Xi'an City ,then polymerase chain reaction restriction fragment length polymorphism (PCR-RLFP) was used to identify HBV genotypes.Results Among 389 cases of HBV Infection in Xi'an City ,58 cases of HBV B genotype accounted for 14.9% (58/389) ,326 cases of HBV C genotype accounted for 83.8% (326/389) and 5 cases of HBV B/C mixed type accounted for 1.2% (5/389).The gender ,HBeAg positive rate ,HBV DNA load level ,ALT and AST had no statistical difference between HBV genotype B and C with the patients(P>0.05);There was no statistically significant in the distribution of B and C genotypes between the pa-tients with chronic hepatitis B and HBV carriers (P>0.05) ,but it had statistical difference between liver cirrhosis and hepatocellu-lar carcinoma(P<0.05).HBV genotype C was easier to develop liver cirrhosis even liver cancer than genotype B.Conclusion The three kinds of HBV genotype B ,C and B/C exist in the HBV infected persons in Xi'an City ,with the genotype C as the main geno-type ,genotype B takes the second and mixed genotype B/C is minimal.The liver cirrhosis occurrence has a certain relationship with the genotype C ,which suggesting that the genotype C is more likely to develop liver cirrhosis.