中华检验医学杂志
中華檢驗醫學雜誌
중화검험의학잡지
CHINESE JOURNAL OF LABORATORY MEDICINE
2009年
10期
1128-1132
,共5页
成军%孙长贵%陈瑜%戴玉柱%许志良%孙关忠%李晓军
成軍%孫長貴%陳瑜%戴玉柱%許誌良%孫關忠%李曉軍
성군%손장귀%진유%대옥주%허지량%손관충%리효군
肝炎%乙型%慢性%肝炎表面抗原%乙型%聚合酶链反应%基因型
肝炎%乙型%慢性%肝炎錶麵抗原%乙型%聚閤酶鏈反應%基因型
간염%을형%만성%간염표면항원%을형%취합매련반응%기인형
Hepatitis B%chronic%Hepatitis B surface antigen%Polymerase chain reaction%Genotype
目的 探讨低浓度HBsAg人群的分子生物学特征及流行病学意义.方法 采用PCR及基因测序的方法 对HBV慢性感染者136份低浓度HBsAg(低浓度HBsAg组)和44份高浓度HBsAg(高浓度HBsAg组)血清标本进行HBV DNA、酪氨酸-蛋氨酸-天冬氨酸-天冬氨酸(YMDD)变异检测,并分别对浓缩法HBV DNA105拷贝/L的47份低浓度HBsAg和37份高浓度HBsAg血清标本进行基因型检测,以及对直接法HBV DNA10~5拷贝/L的14份低浓度HBsAg和29份高浓度HBsAg血清标本进行S基因序列、血清型进行检测分析,S基因序列采用BioEdit软件与中国株参照序列进行比对.结果低浓度HBsAg组HBV DNA阳性率、YMDD变异率和HBV DNA对数值分别为34.6%(47/136)、0(0/136)和6.5±1.4,高浓度HBsAg组分别为84.1%(37/44)、9.1%(4/44)和8.9±1.8,两组之间差异有统计学意义(浓缩法χ~2=30.8,P<0.05;直接法χ~2=53.5,P<0.05;YMDD变异率精确概率法,P=0.003;HBV DNA对数值t=6.5,P<0.05);47例低浓度HBsAg病例中分别检出B基因型16例、C基因型5例、未分型26例,14例血清型分别为adw 7例、ayw4例、adr2例、ayr 1例,在两组人群中基因型的分布差异有统计学意义(χ~2=13.5,P<0.05),血清型的分布差异无统计学意义(χ~2=4.7,P>0.05),S基因测序结果未发现S基因变异,但6处16例次存在核苷酸碱基差异而氨基酸同义的多态性特征.结论 低浓度HBsAg人群HBV DNA存在低复制现象,基因型、血清型分别以B型、adw/ayw为主,S基因呈多态性特征,低浓度HBsAg存在可能与HBV S基因特殊的分子生物学特征使HBsAg表达低下有关,或与患者感染HBV后机体免疫系统的个体反应导致低浓度HBsAg诱导机体免疫耐受有关.
目的 探討低濃度HBsAg人群的分子生物學特徵及流行病學意義.方法 採用PCR及基因測序的方法 對HBV慢性感染者136份低濃度HBsAg(低濃度HBsAg組)和44份高濃度HBsAg(高濃度HBsAg組)血清標本進行HBV DNA、酪氨痠-蛋氨痠-天鼕氨痠-天鼕氨痠(YMDD)變異檢測,併分彆對濃縮法HBV DNA105拷貝/L的47份低濃度HBsAg和37份高濃度HBsAg血清標本進行基因型檢測,以及對直接法HBV DNA10~5拷貝/L的14份低濃度HBsAg和29份高濃度HBsAg血清標本進行S基因序列、血清型進行檢測分析,S基因序列採用BioEdit軟件與中國株參照序列進行比對.結果低濃度HBsAg組HBV DNA暘性率、YMDD變異率和HBV DNA對數值分彆為34.6%(47/136)、0(0/136)和6.5±1.4,高濃度HBsAg組分彆為84.1%(37/44)、9.1%(4/44)和8.9±1.8,兩組之間差異有統計學意義(濃縮法χ~2=30.8,P<0.05;直接法χ~2=53.5,P<0.05;YMDD變異率精確概率法,P=0.003;HBV DNA對數值t=6.5,P<0.05);47例低濃度HBsAg病例中分彆檢齣B基因型16例、C基因型5例、未分型26例,14例血清型分彆為adw 7例、ayw4例、adr2例、ayr 1例,在兩組人群中基因型的分佈差異有統計學意義(χ~2=13.5,P<0.05),血清型的分佈差異無統計學意義(χ~2=4.7,P>0.05),S基因測序結果未髮現S基因變異,但6處16例次存在覈苷痠堿基差異而氨基痠同義的多態性特徵.結論 低濃度HBsAg人群HBV DNA存在低複製現象,基因型、血清型分彆以B型、adw/ayw為主,S基因呈多態性特徵,低濃度HBsAg存在可能與HBV S基因特殊的分子生物學特徵使HBsAg錶達低下有關,或與患者感染HBV後機體免疫繫統的箇體反應導緻低濃度HBsAg誘導機體免疫耐受有關.
목적 탐토저농도HBsAg인군적분자생물학특정급류행병학의의.방법 채용PCR급기인측서적방법 대HBV만성감염자136빈저농도HBsAg(저농도HBsAg조)화44빈고농도HBsAg(고농도HBsAg조)혈청표본진행HBV DNA、락안산-단안산-천동안산-천동안산(YMDD)변이검측,병분별대농축법HBV DNA105고패/L적47빈저농도HBsAg화37빈고농도HBsAg혈청표본진행기인형검측,이급대직접법HBV DNA10~5고패/L적14빈저농도HBsAg화29빈고농도HBsAg혈청표본진행S기인서렬、혈청형진행검측분석,S기인서렬채용BioEdit연건여중국주삼조서렬진행비대.결과저농도HBsAg조HBV DNA양성솔、YMDD변이솔화HBV DNA대수치분별위34.6%(47/136)、0(0/136)화6.5±1.4,고농도HBsAg조분별위84.1%(37/44)、9.1%(4/44)화8.9±1.8,량조지간차이유통계학의의(농축법χ~2=30.8,P<0.05;직접법χ~2=53.5,P<0.05;YMDD변이솔정학개솔법,P=0.003;HBV DNA대수치t=6.5,P<0.05);47례저농도HBsAg병례중분별검출B기인형16례、C기인형5례、미분형26례,14례혈청형분별위adw 7례、ayw4례、adr2례、ayr 1례,재량조인군중기인형적분포차이유통계학의의(χ~2=13.5,P<0.05),혈청형적분포차이무통계학의의(χ~2=4.7,P>0.05),S기인측서결과미발현S기인변이,단6처16례차존재핵감산감기차이이안기산동의적다태성특정.결론 저농도HBsAg인군HBV DNA존재저복제현상,기인형、혈청형분별이B형、adw/ayw위주,S기인정다태성특정,저농도HBsAg존재가능여HBV S기인특수적분자생물학특정사HBsAg표체저하유관,혹여환자감염HBV후궤체면역계통적개체반응도치저농도HBsAg유도궤체면역내수유관.
Objective To investigate the molecular characteristics and epidemiological signification of patients with low-level HBsAg. Methods PCR and gene sequencing were used to detect HBV DNA and Tyr-Met-Asp-Asp(YMDD) mutant in 136 serum samples with low-level HBsAg and 44 sernm samples with high-level HBsAg. Genotyping was performed in 47 cases with HBV DNA 10~5 copies/L by concentration method and 37 cases with high-level HBsAg. S gene sequences and serotypes were analyzed in 14 cases with HBV DNA 105 copies/L and 29 cases with high-level HBsAg. S gene sequences were compared with the consensus sequence of Chinese strain by BioEdit software. Results The HBV DNA-positive rate, YMDD mutation rate and HBV DNA load (logarithm) in low-level and high-level HBsAg group were 34.6% (47/136), 0% (0/136), 6.5±1.4 and 84.1% (37/44), 9.1% (4/44), 8.9±1.8, respectively. There was statistically significant differences between two groups (for concentration method,χ~2 = 30.8, P < 0.05; for direct method, χ~2 = 53.5, P < 0.05; for YMDD mutation ratio, P = 0.003, For HBV DNA (log), t = 6.5, P < 0.05). The genotypes in low-level HBsAg group included type B (16/47), type C (5/47) and non-classified ones(26/47). There were significant differences between two groups (χ~2=21.8, P <0.01). The serotypss included adw (7/14), ayw (4/14), adr (2/14) and ayr (1/14). There were significant differences in genotypes (χ~2 = 13.5, P < 0.05) but not in serotypes between two groups (χ~2 = 4.7, P >0.05). S gene sequencing results showed no S gnne variation was detected, but there were 6 single nucleotide polymorphisms in 16 cases, which would not result in the alternation of amino acid. Conclusions Low-replication phenomenon of HBV DNA was present in patients with low-level HBsAg. The major genotyps and serotype was type B and adw/ayw, respectively. Polymorphic variants have been found in the S gene. The existence of low-level HBsAg might be related with its own molecular characteristics resulting in low expression of HBsAg or immune tolerance induced by low-level HBsAg after HBV infection.
