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目的探讨不同肝病患者乙型肝炎病毒BCP/PC区突变情况。方法选择乙型肝炎患者245例,其中慢性乙型肝炎(CHB)98例、慢性重症肝炎(CSHB)68例、肝硬化(LC)34例及肝癌(HCC)45例,荧光定量PCR测定其基因型,巢氏PCR扩增BCP/PC区基因,分析其在各个肝病组中的分布情况以及与基因型和HBeAg的关系。结果在所检测的245例患者血清中,检测出变异株134例,占54.7%;CSHB组、HCC组和LC组在A1762T/G1764A、G1896A以及联合变异中,其变异频率明显高于CHB组,差异有统计学意义(P<0.01)。CSHB组和LC组比较差异无统计学意义(P>0.05)。C基因型明显高于B型和B+C型的HBV BCP区变异频率,三者比较差异具有统计学意义(P<0.05)。HBeAg阴性组变异率明显高于HBeAg阳性组,差异有统计学意义(P<0.05)。结论 HBV BCP/PC变异中,CSHB组、HCC组和LC组变异频率明显高于CHB组,HBV BCP/PC变异是导致HBeAg阴性的主要机制之一。
Objective To investigate the mutations of BCP / PC region in patients with different liver diseases. Methods A total of 245 hepatitis B patients were selected, including 98 chronic hepatitis B (CHB), 68 chronic severe hepatitis (CSHB), 34 liver cirrhosis (LC) and 45 hepatocellular carcinoma (HCC) Type and nested PCR amplification of BCP / PC region genes, analysis of its distribution in various liver disease groups and genotypes and HBeAg relationship. Results In the serum of 245 patients detected, 134 cases were detected, accounting for 54.7%. In the CSHB, HCC and LC groups, the frequency of mutation in A1762T / G1764A, G1896A and combined mutation was significantly higher than that in CHB group, The difference was statistically significant (P <0.01). There was no significant difference between CSHB group and LC group (P> 0.05). C genotype was significantly higher than that of HBV BCP region of type B and B + C genotypes, the difference was statistically significant (P <0.05). The mutation rate of HBeAg negative group was significantly higher than that of HBeAg positive group, the difference was statistically significant (P <0.05). Conclusion The mutation frequencies of HBV BCP / PC in CSHB, HCC and LC groups were significantly higher than those in CHB group. HBV BCP / PC mutation was one of the main mechanisms leading to negative HBeAg.