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目的 探讨儿童慢性乙肝病毒基本核心启动子 (BCP)基因双变异 (nt176 2A→T和nt176 4G→A)的临床特征和意义。方法 采集空腹肘静脉血 ,分离血清备检 ;以金标层析方法检测乙肝病毒 (HBV)免疫标志物 ,以微板核酸探针杂交技术检测HBVBCP区双位点变异及其DNA定性 ;将研究对象分为轻、中、重 3组 ,分别统计各组BCP双变异阳性率 ,分析BCP区双变异与血清HBeAg的相关性。结果 慢性乙肝患儿HBVDNA检测阳性率82 98% (78/ 94 ) ,HBeAg阳性组显著高于阴性组 (P <0 0 0 1) ;BCP区双变异阳性率为 15 96 % (15 / 94 ) ,HBeAg阳性组明显低于阴性组 (χ2 =5 36 ,P <0 0 5 ) ;轻、中、重 3组HBVBCP变异率分别为 4 4 4 %、13 79%和 4 5 0 0 % ,中、重两组比较差异有显著性 (χ2 =5 91,P <0 0 5 )。结论 儿童慢性乙肝病毒BCP双变异检出率血清HBeAg阴性组明显高于HBeAg阳性组 ,此处双变异减少了但未完全终止HBeAg的产生 ;儿童慢性乙肝HBVBCP双变异发生率与病变程度呈正相关 ,检测BCP区双变异对病情预后的判断有一定参考价值。
Objective To investigate the clinical characteristics and significance of double mutations (nt176 2A → T and nt176 4G → A) of childhood chronic hepatitis B virus (HBV) core promoter (BCP) gene. Methods The fasting cubital vein blood was collected and the serum was separated for detection. The HBV markers were detected by gold standard chromatographic method. The double-site HBV DNA variation and DNA sequencing were detected by the microplate nucleic acid probe hybridization technique. Subjects were divided into three groups: light, medium and heavy. The positive rates of BCP double mutation in each group were calculated respectively, and the relationship between double mutation in BCP region and serum HBeAg was analyzed. Results The positive rate of HBVDNA in children with chronic hepatitis B was 82 98% (78/94), HBeAg positive group was significantly higher than that of negative group (P <0.01 01). The positive rate of double mutation in BCP was 15 96% (15/94) (Χ2 = 536, P <0 05). The mutation rates of HBV BCP in mild, moderate and severe groups were 44.4%, 13.79% and 45.0%, respectively, while those in HBeAg-positive group were significantly lower than those in negative group , The difference between the two groups was significant (χ2 = 5 91, P <0 05). Conclusions The detection rate of BCP double mutation in children with chronic hepatitis B virus is significantly higher than that in HBeAg-positive patients, but double mutation does not completely stop the production of HBeAg. The incidence of HBV BCP double mutation in children with chronic hepatitis B is positively correlated with the degree of disease, Detection of double mutations in BCP area prognosis of the disease have a certain reference value.