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目的:检测乙型肝炎病毒(HBV)不同基因型在慢性无症状携带者(AsC)、慢性乙型病毒性肝炎(CHB)和原发性肝细胞癌(HCC)患者中分布;探讨感染不同基因型HBV导致患者的常用临床实验室结果以及肝脏纤维化指标之间的差别。方法:随机挑选62例AsC、89例CHB和86例HCC患者,采用实时荧光定量聚合酶链反应(FQ-PCR)结合双色荧光标记的Taqman MGB探针来鉴定HBV基因型。实验室检查结果和资料摘抄自患者病案。运用统计软件SPSS10.0对结果进行统计学分析,以P<0.05为差别具有统计学意义。结果:本地区,AsC和CHB患者以感染HBV B基因型为主,分别占80.65%和78.65%;HCC患者以感染C基因型为主,占70.93%。C基因型在HCC组的分布比例明显高于其它两组患者(P<0.001)。在AsC或CHB组内,感染不同基因型的患者常用临床实验室检查指标未显示出明显差别。而在HCC患者中,感染C基因型患者较B基因型e抗原阳性率高(P<0.05)。在CHB和HCC组内感染C基因型较B基因型患者血清HA、LN、PCⅢ含量明显增高(分别为P<0.01,P<0.05和P<0.05),而AsC内均未见有差别。结论:本地区AsC和CHB患者以感染HBV B基因型为主,C基因型和e抗原阳性是HCC发生的危险因素,同时C基因型可能和肝脏高纤维化程度相关。
Objective: To detect the distribution of different genotypes of hepatitis B virus (HBV) in patients with chronic asymptomatic carriers (AsC), chronic hepatitis B (CHB) and primary hepatocellular carcinoma (HCC) HBV causes the difference between patients’ commonly used clinical laboratory results and liver fibrosis markers. Methods: Sixty-two cases of AsC, 89 cases of CHB and 86 cases of HCC were randomly selected and HBV genotypes were identified by real-time fluorescence quantitative polymerase chain reaction (FQ-PCR) combined with two-color fluorescent Taqman MGB probe. Laboratory test results and data extracted from the patient’s medical record. Using statistical software SPSS10.0 statistical analysis of the results to P <0.05 for the difference was statistically significant. Results: In our region, patients with AsC and CHB were predominantly infected with HBV B genotypes, accounting for 80.65% and 78.65% respectively. The majority of HCC patients were infected with genotype C, accounting for 70.93%. The distribution of C genotype in HCC group was significantly higher than the other two groups (P <0.001). In AsC or CHB groups, patients infected with different genotypes of clinical laboratory tests commonly used indicators did not show significant differences. In HCC patients, patients with genotype C had a higher positive rate of e antigen than those with genotype B (P <0.05). The levels of serum HA, LN and PCⅢin patients with genotype C and CHB infection were significantly higher than those with genotype B (P <0.01, P <0.05 and P <0.05, respectively), but no differences were found in AsC. CONCLUSIONS: HBV B genotypes are predominant in patients with AsC and CHB in this region. Positives of C genotype and e antigen are risk factors for HCC. C genotype may be related to the degree of liver fibrosis.