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目的探讨江苏南通地区慢性乙肝病毒(HBV)感染者基因型分布状况及其临床相关性。方法采用多对型特异性引物巢式PCR法对220例南通地区血清HBV标志物和HBV-DNA阳性者,包括乙肝表面抗原携带者(ASC)30例,慢性乙型肝炎(CHB)97例,重型肝炎(CSH)29例,肝炎后肝硬化(LC)34例,肝细胞癌(HCC)30例,进行HBV基因型检测。结果220例中B型59例(26.8%),C型150例(68.2%),BC混合型11例(5.0%);C基因型在CSH组、LC组、HCC组中的比例显著高于ASC组(P<0.05)。B型、C型、BC混合型HBeAg阳性率分别为49.2%、54.0%和36.4%,差异无统计学意义(P>0.05)。C型和BC混合型HBV-DNA载量显著高于B型,差异有统计学意义(P<0.05)。结论南通地区HBV基因型以B、C型为主,C型为优势基因型,并与重型肝炎、肝硬化、肝癌的发生及血清HBV-DNA高载量相关。
Objective To investigate the genotype distribution of chronic hepatitis B virus (HBV) infection in Nantong, Jiangsu Province and its clinical correlation. Methods A total of 220 serum samples of HBV markers and HBV-DNA positive from Nantong area were detected by nested PCR with pairs of specific primers. Among them, 30 were carriers of ASC, 97 were CHB, 29 cases of severe hepatitis (CSH), 34 cases of liver cirrhosis (LC) and 30 cases of hepatocellular carcinoma (HCC). HBV genotypes were detected. Results Among 220 cases, 59 cases (26.8%) were type B, 150 cases (68.2%) were C type and 11 cases (5.0%) were BC mixed type. The proportion of C genotype in CSH group, LC group and HCC group was significantly higher than ASC group (P <0.05). The positive rates of HBeAg in type B, C and BC were 49.2%, 54.0% and 36.4%, respectively, with no significant difference (P> 0.05). The HBV-DNA load of mixed type C and BC was significantly higher than that of type B, the difference was statistically significant (P <0.05). Conclusion The genotypes of HBV genotypes are mainly B and C, and genotype C is the predominant genotype in Nantong area, which is associated with the occurrence of severe hepatitis, cirrhosis and hepatocellular carcinoma and the high serum HBV-DNA load.