中国实用医刊
中國實用醫刊
중국실용의간
CENTRAL PLAINS MEDICAL JOURNAL
2009年
15期
19-21
,共3页
慢性乙型肝炎%拉米夫定%耐药%基因交变%聚合酶链反应
慢性乙型肝炎%拉米伕定%耐藥%基因交變%聚閤酶鏈反應
만성을형간염%랍미부정%내약%기인교변%취합매련반응
Hepatitis B virns%Mutation%Lamivudine%PCR
目的 分析拉米夫定治疗不同时期HBVDNA多聚酶区耐药突变的变化规律和主要耐药突变的分布情况.方法 将接受拉米夫定治疗的98例患者根据治疗时间进行分组,采用PCR方法对其血清HBV多聚酶区进行扩增并对聚合酶链反应(PCR)产物进行直接测序.结果 拉米夫定治疗后血清HBV DNA水平≥104 eopies/ml的患者中,治疗时间<6个月6例,其中1例发生突变;6～12个月13例,其中7例发生突变;12～24个月19例,其中13例发生突变;24～36个月20例,其中19例发生突变,各组之间耐药突变发生率比较差异有统计学意义(P<0.05).耐药患者中有10种突变类型,其中以rtM204I突变最多见,为14例(35..0%),其次为rtL180M/M204V(17.5%)、rtL180M/M2041(12.5%).结论 对拉米夫定治疗6个月以上而没有达到病毒学完全应答的患者进行乙肝病毒基因耐药突变的检测,有助于及时准确的调整治疗方案.
目的 分析拉米伕定治療不同時期HBVDNA多聚酶區耐藥突變的變化規律和主要耐藥突變的分佈情況.方法 將接受拉米伕定治療的98例患者根據治療時間進行分組,採用PCR方法對其血清HBV多聚酶區進行擴增併對聚閤酶鏈反應(PCR)產物進行直接測序.結果 拉米伕定治療後血清HBV DNA水平≥104 eopies/ml的患者中,治療時間<6箇月6例,其中1例髮生突變;6～12箇月13例,其中7例髮生突變;12～24箇月19例,其中13例髮生突變;24～36箇月20例,其中19例髮生突變,各組之間耐藥突變髮生率比較差異有統計學意義(P<0.05).耐藥患者中有10種突變類型,其中以rtM204I突變最多見,為14例(35..0%),其次為rtL180M/M204V(17.5%)、rtL180M/M2041(12.5%).結論 對拉米伕定治療6箇月以上而沒有達到病毒學完全應答的患者進行乙肝病毒基因耐藥突變的檢測,有助于及時準確的調整治療方案.
목적 분석랍미부정치료불동시기HBVDNA다취매구내약돌변적변화규률화주요내약돌변적분포정황.방법 장접수랍미부정치료적98례환자근거치료시간진행분조,채용PCR방법대기혈청HBV다취매구진행확증병대취합매련반응(PCR)산물진행직접측서.결과 랍미부정치료후혈청HBV DNA수평≥104 eopies/ml적환자중,치료시간<6개월6례,기중1례발생돌변;6～12개월13례,기중7례발생돌변;12～24개월19례,기중13례발생돌변;24～36개월20례,기중19례발생돌변,각조지간내약돌변발생솔비교차이유통계학의의(P<0.05).내약환자중유10충돌변류형,기중이rtM204I돌변최다견,위14례(35..0%),기차위rtL180M/M204V(17.5%)、rtL180M/M2041(12.5%).결론 대랍미부정치료6개월이상이몰유체도병독학완전응답적환자진행을간병독기인내약돌변적검측,유조우급시준학적조정치료방안.
Objective To analyze the regulation of lamivudine - mutations at hepatitis B virus (HBV) P gene in the different therapeutic periods and the distribution of major drug - resistant mutations at HBV P gene in patients resistant to lamivudine. Methods Serum sampes from 98 chronic hepatitis B patients with Iamivudine therapy were collected, the HBV P gene RT region from them was amplified by PCR, and PCR products were directly sequenced. Results Among lamivudine- tredted patients with HBV DNA levels above 104 compies/ml, 1 mutation were found in the 6 patients who were treated with lamivadine less than 6 months, 7 found in the 13 patients treated from 6 to 12 months, 13 found in the 1 9patients treated from 12 to 24 months, and 19 patients found in the 20 patients treated from 24 to 36 months,respectively.The incidences of mutations were significantly different in each group (P < 0.05). There were 10 forms of resistant muta-tion in the 40 lamivudine refractorypatients. The major were rtM204I(35.0%) ,rtL180M/M204V(17. 5%). Conclusions It would be helpful to adjust the therapeutic regimen by testing mutations at hepatitis B virus P gene in patients who receive lamivudine therapy more than 6 months without complete virologic response.
