某地区慢性乙型肝炎患者乙肝病毒基因型与临床的相关性研究

目的 了解该地区慢性乙型肝炎(CHB)患者基因型分布的特点,探讨基因型与临床之间的相关性.方法 采用荧光PCR方法检测256例CHB患者的HBV基因型,同时检测血清HBV DNA、HBV-M、肝功能等,并对其与性别、年龄、肝功能及病毒复制水平的关系进行分析.结果 256例CHB患者B基因型84例(32.81%),C基因型148例,B+C混合型24例.C基因型为优势基因型(χ2=17.66,P＜0.01);B基因型患者血清HBeAg阳性率76.19%,显著低于C基因型血清HBeAg阳性率86.49%(χ2=3.981,P＜0.05);C基因型患者的ALT、AST及TBIL均高于B型,但差异无统计学意义(P＞0.05).男、女性别中均以C基因型占优势,分别为67.56%和32.43%,差异有统计学意义 (χ2=6.10,P＜0.05;χ2=16.00,P＜0.01);C基因型平均年龄(32.38±13.90)岁,明显高于B基因型平均年龄(28.95±10.84)岁,差异有统计学意义(t=5.15,P＜0.01).结论 该地区CHB患者HBV基因型以C型为主,C型血清HBeAg阳性率高于B型.

Distribution and clinical significance of hepatitis B virus genotypes in patients with chronic hepatitis B

Objective To investigate the distribution of hepatitis B virus (HBV) genotypes in patients with chronic hepatitis B,and to explore the significance and the relationship of the HBV genotype with sex,age and HBV replication.Methods The genotypes of HBV were detected with fluorescence quantitative PCR.The relationships between HBV genotype and sex,age and serological data of 256 cases of patients with chronic hepatitis B were analyzed.Results Genotype B,C and B/C were determined,with 32.81%(84/256) for genotype B,57.81%(148/256) for genotype C,and 9.38%(24/256) for genotype B+C.There was a statistically significant difference between the distribution of genotype B and C(χ2=17.66,P<0.01).Genotype C was the dominant genotype.The positive rate of HBeAg was significantly lower in patients with genotype B than with genotype C(χ2=3.981,P<0.05).The ALT、AST and TBIL levels were lower in patients with genotype B than with genotype C,but no statistically significant difference was confirmed (P>0.05).There was a statistically significant difference between the age of patients with genotype B or C(t=5.15,P<0.01).Conclusion HBV genotype C might be the major genotype in patients with chronic hepatitis B in this area,and the positive rate of HBeAg in patients with genotype C was higher than with genotype B.