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目的研究外周血单个核细胞（ＰＢＭＣ）中乙型肝炎病毒（ＨＢＶ）包膜抗原基因变异的意义。方法收集１９例慢性乙肝患者的ＰＢＭＣ和配对血清，用ＰＣＲ扩增ＰＢＭＣ及血清中ＨＢＶ包膜基因片段（Ｓ，ｐｒｅＳ１，ｐｒｅＳ２），并对其中各５例ＰＢＭＣ及配对血清中的ｐｒｅＳ１和ｐｒｅＳ２基因片段，分别进行核苷酸序列分析。结果Ｓ、ｐｒｅＳ１和ｐｒｅＳ２片段在血清和ＰＢＭＣ中的检出率，分别为１００％、９４７％、１００％和０、２６３％、２６３％。与ＨＢＶＡＤＲ序列比较，１０份标本ＨＢＶＤＮＡ核苷酸序列分析，发现２份ｐｒｅＳ１和３份ｐｒｅＳ２的核苷酸序列，没有发生改变；８份ｐｒｅＳ１和７份ｐｒｅＳ２的核苷酸序列，均发生了一个至多个位点的点突变。结论ＰＢＭＣ中存在的包膜基因不完整，因而不会形成完整的ＨＢＶ病毒颗粒，故不支持ＨＢＶ可潜伏于ＰＢＭＣ并发展成为体内ＨＢＶ再感染的来源。ｐｒｅＳ１点突变编码的氨基酸位点，集中在ａａ２１～４７区域，可能会影响ＨＢＶ的吸附和穿入，及组织亲嗜性的改变。ＨＢＶ亚基因片段在ＰＢＭＣ中，是否会影响细胞的功能，有待进一步研究。
Objective To investigate the significance of hepatitis B virus (HBV) envelope antigen gene mutation in peripheral blood mononuclear cells (PBMCs). Methods PBMCs and matched sera from 19 chronic hepatitis B patients were collected. The HBV envelope gene fragments (S, preS1, preS2) in PBMC and serum were amplified by PCR, and the preS1 and preS2 genes in 5 PBMCs and matched serum Fragment, respectively, for nucleotide sequence analysis. Results The detection rates of S, preS1 and preS2 in serum and PBMC were 100%, 947%, 100% and 0,263%, 263% respectively. Compared with the HBVADR sequence, the nucleotide sequence of the HBVDNA in 10 samples showed no change in the nucleotide sequence of 2 copies of preS1 and 3 copies of preS2. One nucleotide sequence of 8 copies of preS1 and 7 copies of preS2 Point mutations to multiple sites. Conclusion The envelope genes in PBMC are incomplete and therefore do not form a complete HBV virion. Therefore, they do not support that HBV can be latent in PBMC and develop into a source of HBV re-infection in vivo. PreS1 point mutation encoded amino acid sites, concentrated in aa21 ~ 47 area, may affect the adsorption and penetration of HBV, and tissue changes in the tropism. HBV subunit fragment in PBMC, will affect the function of cells, pending further study.