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目的 了解拉米夫定耐药与HBV基因型及HBV基本核心启动子 (BCP)突变之间的关系。方法 选取HBV前C区保守序列作为通用包被探针 ,HBV不同基因型 (A、B、C、D、E、F)的序列、BCP野生株及突变株的序列、YMDD野生株及突变株序列分别作多条显色探针。采用PCR微板核酸杂交ELISA技术分别对服药前及服药后 6个月进行HBV含量、基因型、BCP突变株及YMDD突变株的检测。结果 HBVC基因型占 36 % ,B基因型占 30 % ,D基因型占 2 3%。服药前 13例BCP突变患者仅 1例为B型 ,C型 8例 ,D型 4例 ;13例中有 2例DNA浓度小于 10 0pg ml血清 ,11例DNA浓度均大于 10 0pg ml血清。口服拉米夫定 6个月 ,YMDD突变株发生率为 9.4% ,在 5例YMDD突变中 ,C基因型 3例 ,D基因型 2例。并且 4例伴有BCP双突变。结论 HBVBCP的突变株HBV基因型及DNA含量有一定的相关性。口服拉米夫定可以明显降低HBV水平 ,HBVYMDD突变株的发生也与基因型有关 ,且 80 % (4 5 )伴有BCP双突变
Objective To understand the relationship between lamivudine resistance and HBV genotype and HBV basic core promoter (BCP) mutation. Methods The conserved sequences of HBV pre-C region were selected as universal probe and the sequences of HBV genotypes (A, B, C, D, E, F), the wild-type and mutant strains of BCP, the YMDD wild- The sequences were made as multiple chromogenic probes. HBV DNA, genotypes, BCP mutants and YMDD mutants were detected before and after taking the drug by PCR microplate nucleic acid hybridization ELISA. Results HBVC genotype accounted for 36%, B genotype accounted for 30%, D genotype accounted for 23%. Only 13 cases of BCP mutation had type B, 8 cases of type C and 4 cases of type D in the first 13 cases. The DNA concentration of two cases was less than 10 0 pg ml in 13 cases, and the DNA concentration was higher than 10 0 pg ml in 11 cases. Six months after oral administration of lamivudine, the incidence of YMDD mutant was 9.4%. Among 5 YMDD mutations, 3 were C genotype and 2 were D genotype. And 4 cases with BCP double mutation. Conclusion HBV genotypes and DNA content of HBV BCP mutant strains are related to each other. Oral Lamivudine can significantly reduce the level of HBV, HBVYMDD mutant genotypes also occur, and 80% (45) with BCP double mutation