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目的 研究乙型肝炎病毒 (HBV)基本核心启动子 (BCP)T176 2 /A176 4双突变及前C区A1896突变与肝脏损伤程度的相关性。方法 2 0 0 0～ 2 0 0 2年哈尔滨医科大学附属第二医院及广东省廉江市医院随机选取 113例慢性HBV感染者 ,采用INNO -LiPA法测定HBVBCPT176 2 /A176 4双突变及前C区A1896突变 ,同时测定HBVS基因序列明确基因型。结果 CHB组、LC组、HCC组BCPT176 2 /A176 4双突变率明显高于AsC组 (分别为 2 4 . 1%比 2. 8% ,χ2 =5 .93,P <0 . 0 5 ;71. 4 %比 2 .8% ,χ2 =2 3 .83,P <0 .0 1和 5 5 . 6 %比 2 .8% ,χ2 =13. 0 9,P <0 . 0 1) ,LC组BCPT176 2 /A176 4双突变率显著高于CHB组 (71 .4 %比 2 4 . 1% ,χ2 =9 .12 ,P <0 .0 1) ;单一C基因型感染者CHB、LC和HCC组BCPT176 2 /A176 4双突变率明显高于AsC组 (分别为 33 .3%比 5 . 3% ,χ2 =3 .89,P <0 .0 5 ;6 9 .2 %比5 . 3% ,P <0 . 0 1和 5 0 .0 %比 5. 3% ,P <0 . 0 5 )。各组前C区A1896突变率均较低 ,在CHB组和LC组无一例发生 ;HCC组前C区A1896突变率与AsC组比较差异无显著性 (11 .1%比 8. 3% ,χ2 =0 . 0 0 ,P >0 . 0 5 )。结论 在慢性HBV感染者中 ,BCPT176 2 /A176 4双突变与慢性肝病进展有关。
Objective To study the relationship between hepatitis B virus (HBV) basic core promoter (BCP) T176 2 / A176 4 double mutation and pre-C region A1896 mutation and liver injury. Methods Totally 113 patients with chronic HBV infection were randomly selected from the Second Affiliated Hospital of Harbin Medical University and Lianjiang Hospital of Guangdong Province from 2000 to 2002. The double mutations of HBV BCPT176 2 / A176 4 and the former C Region A1896 mutation, HBV genotypes were also determined. Results The double mutation rate of BCPT176 2 / A176 4 in CHB group, LC group and HCC group was significantly higher than that in AsC group (respectively, 24.1% vs 2.8%, χ2 = 5.93, P <0.05; 71 .4% vs2.8%, χ2 = 23.383, P <0.01 and5.5.6% vs2.8%, χ2 = 13.019, P <0.01), LC The double mutation rates of BCPT176 2 / A176 4 in CHB group were significantly higher than those in CHB group (71.4% vs 24.1%, χ2 = 9.12, P <0.01) The double mutation rate of BCPT176 2 / A176 4 in HCC group was significantly higher than that in AsC group (33.3% vs 5.3%, χ2 = 3.89, P <0.05; 69.2% vs5.3, respectively %, P <0. 0 1 and 50.0% vs. 5.3%, P <0. 05). The mutation rate of A1896 in pre-C region of each group was low, but no one occurred in CHB group and LC group. The mutation rate of A1896 in pre-C region of HCC group was not significantly different from that in AsC group (11.1% vs 8.3%, χ2 = 0. 0 0, P> 0. 0 5). Conclusion In patients with chronic HBV infection, BCPT176 2 / A176 4 double mutations are associated with the progress of chronic liver disease.