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目的应用聚合酶链反应-限制性酶切片段长度多态性分析(PCR-RFLP)法检测慢性乙型肝炎HBV DNA前C区变异与干扰素(IFN)治疗的关系。方法将中国医科大学附属盛京医院1996—1997年收治的200例符合临床诊断标准的慢性乙型肝炎患者,随机分为治疗组和对照组,治疗组应用常规保肝药物加IFN-α共同治疗,对照组只应用常规保肝药物治疗,疗程为6个月。治疗前后分别收集两组患者血清,用PCR-RFLP法检测前C区1896位变异情况。结果治疗前,治疗组变异株检出率为20%(20/100),对照组变异株检出率为18%(18/100);两组变异株检出率相比差异无统计学意义(P>0.05)。治疗后,治疗组变异株病毒感染的慢性乙型肝炎者20例治疗有效率为60%(12/20),野毒株病毒感染的慢性乙型肝炎患者80例治疗有效率为50%(40/80);而对照组变异株、野毒株病毒感染的慢性乙型肝炎患者治疗有效率均为0。结论IFN治疗无诱发HBV前C区1896位变异的作用,IFN治疗变异株病毒感染的慢性乙型肝炎有效,IFN治疗变异株病毒感染的慢性乙型肝炎近期疗效与野毒株基本相同。
Objective To detect the relationship between the pre-C mutation of HBV DNA and the treatment of interferon (IFN) in patients with chronic hepatitis B by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP). Methods 200 cases of chronic hepatitis B patients who were clinically diagnosed in Shengjing Hospital of China Medical University from 1996 to 1997 were randomly divided into treatment group and control group. The treatment group was treated with conventional hepatoprotective drugs plus IFN-α , The control group only conventional hepatoprotective drugs, treatment for 6 months. Before and after treatment were collected two groups of patients serum, using PCR-RFLP method to detect 1896 pre-C mutation. Results Before treatment, the detection rate of mutation in the treatment group was 20% (20/100), while that in the control group was 18% (18/100). There was no significant difference in the detection rate between the two groups (P> 0.05). After treatment, 20 cases of chronic hepatitis B virus infection in the treatment group were treated 60% (12/20), 80 cases of chronic hepatitis B patients infected with wild virus were 50% (40% / 80); while the control group of mutant strains, wild-type virus infection in patients with chronic hepatitis B treatment efficiency were 0. CONCLUSION: IFN treatment did not induce the mutation of 1896 positions in pre-HBV precancerous lesion. IFN treatment of variant hepatitis B virus was effective in treating chronic hepatitis B. The short-term curative effect of IFN treatment of virus-infected chronic hepatitis B was basically the same as that of wild-type strain.