目的探讨拉米夫定治疗乙型肝炎过程中病毒基因分型、病毒含量、及治疗时间与拉米夫定突变株(YMDD)的相关性。方法对应用拉米夫定治疗的46例慢性乙型肝炎患者进行病毒含量、病毒基因分型、HBVYMDD变异检测。结果不同基因分型患者,病毒含量不同,出现不同程度YMDD变异。结论 YMDD变异与基因分型无明显相关性,治疗前血清HBV DNA含量越高,越易出现YMDD变异。出现YMDD变异患者,肝组织内处于不同的炎症及纤维化状态。 Objective To investigate the relationship between viral genotyping, viral load, and treatment duration in patients with lamivudine during lamivudine treatment of hepatitis B virus (YMDD). Methods 46 cases of chronic hepatitis B patients treated with lamivudine were tested for the virus content, viral genotyping and HBVYMDD mutation. Results Different genotyping patients, the virus content is different, there are varying degrees of YMDD mutation. Conclusion There is no significant correlation between YMDD mutation and genotyping. The higher the serum HBV DNA before treatment, the more likely YMDD mutation occurs. Patients with YMDD mutations present different inflammatory and fibrotic states in the liver tissue.