CAJ | 학술논문

目的：分析拉米夫定耐药的慢性乙型肝炎患者HBV P区变异和基因分型的关系，为制定针对不同HBV基因型抗病毒的个体化方案提供依据。方法应用聚合酶链反应（ PCR）和酶联免疫吸附试验（ ELISA）对187例拉米夫定耐药患者的HBV DNA载量及HBV-M进行检测，用特异的引物对待检标本HBV P区进行全序列测定，对不同性别、年龄的测序结果的基因分型作比较；并对C、B基因型发生实变模式作分析。结果187例慢性乙型肝炎患者感染的HBV均为B和C基因型，B基因型51例（27.27%），C基因型134例（71.66%），并存在混合感染2例（1.07%）；HBeAg含量在B基因型和C基因型间差异有统计学意义（ P<0.05）；P区基因突变结果显示，B基因型以单纯YMDD突变为主，C基因型以YMDD突变+ rtL180M 突变为主。结论本研究对象的HBV基因型主要是C型，不同基因型可能决定了与耐药相关的P区变异模式。
목적：분석랍미부정내약적만성을형간염환자HBV P구변이화기인분형적관계，위제정침대불동HBV기인형항병독적개체화방안제공의거。방법응용취합매련반응（ PCR）화매련면역흡부시험（ ELISA）대187례랍미부정내약환자적HBV DNA재량급HBV-M진행검측，용특이적인물대대검표본HBV P구진행전서렬측정，대불동성별、년령적측서결과적기인분형작비교；병대C、B기인형발생실변모식작분석。결과187례만성을형간염환자감염적HBV균위B화C기인형，B기인형51례（27.27%），C기인형134례（71.66%），병존재혼합감염2례（1.07%）；HBeAg함량재B기인형화C기인형간차이유통계학의의（ P<0.05）；P구기인돌변결과현시，B기인형이단순YMDD돌변위주，C기인형이YMDD돌변+ rtL180M 돌변위주。결론본연구대상적HBV기인형주요시C형，불동기인형가능결정료여내약상관적P구변이모식。
Objective To analyze hepatitis B virus( HBV)genotype and the correlation between variation of P gene region and genotyping of Lamivudine-resistant HBV,in order to provide molecular virology basis for anti-virus individualized treatment to different HBV genotypes. Methods Serum markers and HBV DNA of 187 Lamivudine -resistant chronic HBV patients were detected by ELISA and fluorescent quantitative polymerase chain reaction. Moreover,DNA Star and viral genotyping tool were used. Results Of the 187 cases infected with HBV genotype B and C,51 cases were B gene (27. 27%),134 cases were C gene(71. 66%),and 2 cases were mixed infections(1. 07%). HBeAg levels were significantly different between genotype B and C(P<0. 05). P gene mutation results showed that genotype B dominated by YMDD mutation alone and genotype C dominated by YMDD and rtL180M mutation. Conclusion The main HBV genotype of this study is genotype C,and different genotypes may determine the variation patterns of P region which associated with resistance.