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[目的]探讨慢性乙型肝炎(CHB)患者在服用拉米夫定后HBV-DNA聚合酶活性区(P基因区)发生YM-DD(酪氨酸-蛋氨酸-天门冬氨酸-天门冬氨酸)变异的相关影响因素。[方法]分别用荧光定量PCR法、微粒酶免分析方法及速率法检测156例用拉米夫定治疗的CHB患者YMDD变异情况、HBV-DNA定量水平、血清学标志物及丙氨酸氨基转移酶ALT等指标。[结果]156例患者中,治疗前检出5例YMDD变异(3.2%),治疗1年后YMDD变异率为30.1%(47/156)。变异组治疗前HBV-DNA含量高于未变异组,而未变异组治疗前谷丙转氨酶(ALT)水平高于变异组。HBeAg阳性组与阴性组的YMDD变异率类似。YMDD未变异组与变异组的患者性别、年龄类似。[结论]HBVYMDD变异可能与患者治疗前ALT水平和HBV-DNA含量有一定关系,而与患者的性别、年龄和血清HBeAg状态无关。
[Objective] To investigate the effect of YM-DD (tyrosine-methionine-aspartate-aspartate) on the HBV DNA polymerase activity region (P gene region) in chronic hepatitis B (CHB) patients after taking lamivudine Acid) variation related factors. [Methods] The variation of YMDD, HBV-DNA level, serological markers and alanine aminotransferase in 156 CHB patients treated with lamivudine were detected by fluorescence quantitative PCR, enzyme-linked immunosorbent assay and rate assay, respectively ALT and other indicators. [Results] Among the 156 patients, 5 cases of YMDD mutation (3.2%) were detected before treatment, and the YMDD mutation rate was 30.1% (47/156) after 1 year of treatment. In the mutation group, the content of HBV-DNA before treatment was higher than that in the non-mutation group, while the ALT level in the non-mutation group was higher than that in the mutation group. The mutation rates of YMDD in HBeAg positive and negative groups were similar. The gender and age of patients in YMDD non-mutation group and mutation group were similar. [Conclusion] The variation of HBVYMDD may be related to the level of ALT and the content of HBV-DNA before treatment, but not with the gender, age and serum HBeAg status.