论文部分内容阅读
目的 :研究乙型肝炎病毒前 - C区 G1896 A突变和基本 C区启动子区 A176 2 T、 G176 4 A双突变对拉米呋啶治疗的影响。方法 :采用直接测序法对服药前、中、后的血清标本的逆转录多聚酶区及前 - C、基本 C区启动子区进行检测。结果 :1前 - C区 G1896 A和基本 C区启动子区 A176 2 T、G176 4 A双突变在出现治疗中病毒学反弹与未出现治疗中病毒学反弹患者间及发生血清学转移与未发生血清学转换患者间差异无显著性 (P>0 .0 5 ) ;2 G1896 A突变在发生 YMDD变异和未发生 YMDD变异的患者间差异有显著性 (P<0 .0 5 ) ,发生 YMDD变异的患者很少伴有 G1896 A突变率低 (9% ) ;3出现治疗中病毒学反弹的患者 YMDD变异增加 ,与未出现治疗中病毒学反弹的患者比较差异有显著性 (P<0 .0 5 )。结论 :前 - C区 G1896 A和基本 C区启动子区 A176 2 T、 G176 4 A双突变对拉米呋啶治疗后出现的治疗中病毒学反弹和血清学转换没有影响 ;在 G1896 A突变株 YMDD变异减少 ;YMDD变异株的出现对治疗后出现的治疗中病毒学反弹有影响 ;YMDD变异可能是加剧肝细胞损伤引起治疗中病毒学反弹的因素之一。
Objective: To study the effect of G1896 A mutation in hepatitis B virus pre-C region and A176 2 T, G176 4 A double mutation in basic C region promoter on lamivudine treatment. Methods: Reverse transcriptase polymerase chain reaction (PCR) and pre-C, basic C region promoter region of serum samples before, during and after medication were detected by direct sequencing. RESULTS: A double mutation of A176 2 T and G176 4 A in pre-C region G1896 A and basic C region promoter was associated with the occurrence of serological metastasis and non-occurrence of virological rebound in the treatment of patients with virological rebound and the absence of treatment There was no significant difference between patients with seroconversion (P> 0.05); 2 G1896 A mutation was significantly different between patients with YMDD and without YMDD (P <0.05), with YMDD mutation (9%) of patients with G1896 A had fewer mutations; (3) YMDD mutation increased in patients with virological rebound after treatment, which was significantly different from those without virological rebound (P <0. 0) 5). CONCLUSION: The double mutations of A176 2 T and G176 4 A in pre-C region G1896 A and basic C region promoters have no effect on virological rebound and seroconversion during the treatment of lamivudine. In G1896 A mutant YMDD mutation decreased; YMDD mutation appeared in the treatment of virological rebound after impact; YMDD mutation may be aggravated liver cell damage caused by the treatment of virological rebound factor.