[1]何紫琪,李从荣,尹 路.乙型肝炎病毒逆转录酶基因突变的临床意义[J].现代检验医学杂志,2016,31(04):83-86.[doi:10.3969/j.issn.16717-414.2016.04.022]
　HE Zi-qi,LI Cong-rong,YIN Lu.Clinical Significance of Reverse Transcriptase Gene Mutations in the Hepatitis B Virus[J].Journal of Modern Laboratory Medicine,2016,31(04):83-86.[doi:10.3969/j.issn.16717-414.2016.04.022]
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乙型肝炎病毒逆转录酶基因突变的临床意义()
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《现代检验医学杂志》[ISSN:/CN:]

卷:
第31卷
期数:
2016年04期
页码:
83-86
栏目:
论著
出版日期:
2016-08-10

文章信息/Info

Title:
Clinical Significance of Reverse Transcriptase Gene Mutations in the Hepatitis B Virus
文章编号:
1671-7414(2016)04-083-04
作者:
何紫琪; 李从荣; 尹 路
武汉大学人民医院检验科,武汉 430060
Author(s):
HE Zi-qi; LI Cong-rong; YIN Lu
Departmentof Clinical Laboratory, Renmin Hospital of Wuhan University,Wuhan 430060,China
关键词:
乙型肝炎病毒;  逆转录酶基因;  耐药突变;  生化指标
分类号:
R512.62; Q754
DOI:
10.3969/j.issn.16717-414.2016.04.022
文献标志码:
A
摘要:
目的 分析服用核苷酸类似物的乙肝患者逆转录酶(RT)基因突变模式及其与生化指标的相关性,探讨该基因突变的临床意义。方法 采用半巢式PCR对634例来自武汉地区的乙肝病毒感染者血浆HBV进行扩增后,Sanger测序法进行基因序列分析; 将RT基因突变组与野生组和各表型突变组中患者的谷氨酸氨基转移酶(ALT)、乙肝病毒e抗原(HBeAg)和HBV DNA阳性率作比较。结果 在测序成功的622例患者中,144例(23.15%)发生RT基因突变。他们在11个位点(rtM204,rtL180,rtA181,rtN236,rtV173,rtL80,rtM250,rtS202,rtV207,rtV214和rtV84)出现碱基突变。在突变组中,患者的ALT,HBeAg和HBV DNA阳性率显著高于非突变组(P<0.05)。表型分析显示:拉米夫定(LAM)耐药最常检测到,占52.78%,其次为阿德福伟(ADV)耐药占27.78%和恩替卡韦(ETV)耐药占6.94%,多重耐药LAM+ADV于18例患者中检出12.5%。多重耐药组患者ALT,HBeAg和HBV DNA阳性率高于其他耐药组(P<0.05); ADV耐药组患者ALT,HBeAg和HBV DNA阳性率高于LAM,ETV耐药组。结论 HBV RT区域的突变形式与血清学指标ALT,HBeAg和HBV DNA阳性状态有显著关联,该基因的突变形式可用作患者临床表现的指示指标。
Abstract:
Objective To explore the clinical significanceof RT mutations through analyzing the mutation patterns and their biochemical parameters of the nucleotide analog treatment patients.Methods 634 plasma from HBV patients infected with HBV were amplified by semi-nested PCR,and then analyzed by Sanger DNA sequencing.ALT,HBeAg and HBV DNA positive rate were compared between mutation group vs.wild group and different mutation pattern groups.Results Among the 622 patients who were amplified successfully,144(23.15%)had RT gene mutations.They showed thefollowing mutation patterns in 11 sites:rtM204,rtL180,rtA181,rtN236,rtV173,rtL80,rtM250,rtS202,rtV207,rtV214 and rtV84.In the mutated group,ALT,HBeAg and HBV DNA positive rates were significantly higher(P<0.05).Phenotypic analysis showed that lamivudine resistance was most frequently detected(52.78%),followed by adefovir resistance(27.78%)and entecavir resistance(6.94%).Multidrug resistance was detected in 18 cases(12.5%).The LAM+ADV resistantgroup had a higher proportion of cases in ALT,HBeAg and HBV DNA positive rate,and the ADV-resistant group also had a higher proportion of cases than othertwo grous.Conclusion The results in our study shows correlations between the mutation status of the RT domain and biochemical parameters suchas ALT,HBeAg and HBV DNA positive rates.The presence of RT gene mutations could therefore be utilized as a predictor of clinical status.

参考文献/References:

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备注/Memo

备注/Memo:

作者简介:何紫琪(1989-),女,在读硕士,主要从事病原微生物快速检测研究。
通讯作者:李从荣,女,硕士研究生导师,E-mail:congrongli33@hotmail.com。
更新日期/Last Update: 2016-08-10