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目的：研究乙型肝炎病毒（ Ｈ Ｂ Ｖ）前 Ｓ１／ Ｓ２ 基因变异规律及其与 Ｈ Ｂ Ｖ 感染临床转归的关系。方法：选择急性自限性乙型肝炎患者、慢性 Ｈ Ｂ Ｖ 携带者及慢性重型乙型肝炎患者各３ 例，用半巢式 Ｐ Ｃ Ｒ 法从此９ 例 Ｈ Ｂ Ｖ 感染者血清中扩增出前 Ｓ１／ Ｓ２ 片段，并用标准分子生物学方法对 Ｐ Ｃ Ｒ 产物进行克隆和序列分析。每个 Ｈ Ｂ Ｖ 感染者随机选择１０ 个克隆，总共测定了９０ 个克隆。通过核苷酸、氨基酸序列同源性比较分析前 Ｓ１／ Ｓ２ 区内肝细胞结合位点、 Ｂ细胞表位和前 Ｓ１、 Ｓ２ 调控区的缺失状况。结果：不同转归的 Ｈ Ｂ Ｖ 感染者体内的 Ｈ Ｂ Ｖ 前 Ｓ１／ Ｓ２ 变异具有明显不同的特征。急性自限性乙型肝炎：前 Ｓ１／ Ｓ２ 各功能区稳定， Ｔ、 Ｂ细胞表位无变化。慢性 Ｈ Ｂ Ｖ 携带者：前 Ｓ１／ Ｓ２ 各功能区变异较大，存在着 Ｔ、 Ｂ细胞表位的漂移。慢性重型乙型肝炎：优势株内可能存在引起机体免疫性增高的区域。结论：本研究为较全面地了解 Ｈ Ｂ Ｖ 前 Ｓ１／ Ｓ２ 功能区变化与临床转归的可能联系提供了实验依据。
Objective: To study the variation of pre-S1 / S2 gene mutation in hepatitis B virus (HBV) and its relationship with the clinical outcome of Hb V infection. Methods: Three patients with acute self-limited hepatitis B, chronic Hb V carriers and chronic severe hepatitis B were selected. The hemoglobin S1 / S2 fragment, and the P C R product was cloned and sequenced using standard molecular biology methods. Ten clones were randomly selected for each HBV infection and a total of 90 clones were determined. The nucleotide and amino acid sequence homology was compared to analyze the deletion of hepatocyte-binding sites, B-cell epitopes and pre-S1 and S2 regulatory regions in pre-S1 / S2 regions. RESULTS: The pre-S1 / S2 H B V variants in different H B V-infected individuals had significantly different characteristics. Acute self-limiting hepatitis B: Pre-S1 / S2 functional areas stable, T, B cell epitopes did not change. Chronic H B V carrier: pre-S1 / S2 each functional area variation, there T, B cell epitopes drift. Chronic severe hepatitis B: There may be areas in the dominant strain that cause increased immunity. CONCLUSION: This study provides experimental evidence for a more complete understanding of the possible association between changes in pre-S1 / S2 functional regions of H B V and clinical outcomes.