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目的了解温州地区乙型肝炎病毒(HBV)基因型的分布及其与临床的相关性。方法选取温州地区HBVDNA阳性的慢性HBV感染者202例,其中慢性无症状乙型肝炎表面抗原携带者52例,慢性乙型肝炎103例,肝硬化27例,肝细胞癌20例,应用型特异性引物巢式PCR检测HBV的基因型。结果202例HBV DNA阳性血清标本中,B型37例(18.3%),C型123例(60.9%),B/C混合型41例(20.3%),D型1例(0.5%),未发现A、E、F和G型;与B基因型、B/C混合型相比,C基因型在慢性乙型肝炎和肝细胞癌中明显升高,分别为56.1%和14.6%(P(0.05);C基因型感染者血清丙氨酸氨基转移酶水平(226±268)U/L高于B基因型的(114±183)U/L和B/C混合型的(130±222)U/L,差异有统计学意义(P(0.05);C基因型感染者HBeAg阳性率和HBV DNA含量明显高于B基因型和BC混合型感染者相比,差异有统计学意义(P(0.05)。结论温州地区存在HBV的B、C、D和B/C混合基因型,C型为本地区的优势基因型,并且C型HBV感染易引起较重肝脏损伤。
Objective To understand the distribution of hepatitis B virus (HBV) genotypes in Wenzhou and its clinical relevance. Methods Totally 202 HBVDNA positive chronic HBV infected patients were enrolled in Wenzhou. Among them, 52 were carriers of chronic asymptomatic hepatitis B surface antigen, 103 were chronic hepatitis B, 27 were liver cirrhosis and 20 were hepatocellular carcinoma. Primer nested PCR detection of HBV genotypes. Results Among 202 HBV DNA positive serum samples, 37 (18.3%) were type B, 123 (60.9%) were C, 41 (20.3%) were B / C mixed and 1 The genotypes C, A, E, F and G were found to be significantly higher in patients with chronic hepatitis B and hepatocellular carcinoma than those with genotype B and B / C (56.1% and 14.6%, P 0.05). The serum alanine aminotransferase levels in patients with genotype C (226 ± 268) U / L were significantly higher than those in genotypes B (114 ± 183) U / L and B / C (130 ± 222) U / L, the difference was statistically significant (P (0.05); HBeAg positive rate and HBV DNA content in patients with genotype C were significantly higher than those in genotype B and BC, the difference was statistically significant (P 0.05) .Conclusion HBV genotypes B, C, D and B / C exist in Wenzhou area, while genotype C is the predominant genotype in this area. HBV infection of type C may cause severe liver injury.