HBV-DNA-pre-C区(nt1896)变异的临床调查与分析

目的 探讨近一年里乙型肝炎患者感染HBV-pre-C区段变异病毒株的形式并分析其意义。方法 以PCR-酶免定量检测方法检测乙肝“两对半”测定模式为HBsAg(+)及抗-HBc(+)的60例及“大三阳”、“小三阳”各20例患者血清中HBV-per-C区段变异(nt1896变异)的阳性比例,并同时检测ALT的活性。以体检健康者30例为检测对照。结果 HBsAg(+)及抗-HBc(+)的检样组血清中有32例呈HBV-pre-C区段变异(nt1896变异)阳性,阳性率为53.3％,显著高于“大三阳”(4/20)病例及正常对照组(P<0.01),而与“小三阳”组变异阳性率(11/20)没有显著性差异(P>0.05),32例变异阳性中有30例伴有血清ALT活性病理性增高,比率为93.7％;4例“大三阳”变异阳性者均伴有血清ALT活性的病理性增高(100％);而11例“小三阳”变异阳性者中9例(81.8％)伴有血清ALT活性的病理性增高,三组病例变异阳性伴血清ALT活性增高率间没有显著性差异(P>0.05)。结论 HBeAg(一)的乙型肝炎较容易发生HBV-pre-C区段(nt1896)变异,应引起临床诊断及治疗的足够重视。同时也可反映该地区急、慢性乙型肝炎病原感染的部分特征。

Clinical Testing and Estimation of HBV Precore Mutant

Objective To observe the form about the HBV precore mutant in HBV patient in hospital for one year recently. Methods Tested HBV precore mutant(1896 G-A point mutation) in HBV patient included 60 samples with HBsAg(+) and anti-HBc(+))20 samples with HBs Ag (+), HBeAg (+) and anti-HBc (+) ;20 samples with HBsAg(+) ,anti-HBe (+) and anti-HBc(+) by PCR-ELA,in the same time we tested serum-ALT in all mutanted samples. And 30 healthy cases were used to be compared. Results HBV precore mutant(1896 G-A point mutation)existed popularly in all samples,but the detective rate of HBV precore mutant(1896 G-A point mutation) in HBeAg(-) groups(53. 3% .55. 0%)were significantly higher than that in HBeAg(+) group(20. 0%)(P-<0. 01). The serum-ALT pathologyical increasing in most of the sampies with HBV precore mutant(1896 G-A point mutation), and that had not statistical significance (P>0. 05) in 3 groups of HBV patien. Conclusions HBV precore mutant (1896 G-A point mutation )is more frequently observed in HBeAg (-) group than HBeAg(+)group;It must be paid attention by clinical diagnose and treatment. In other hand.it could report some feature about HBV precore mutant in local.