中华肝脏病杂志
中華肝髒病雜誌
중화간장병잡지
CHINESE JOURNAL OF HEPATOLOGY
2014年
7期
484-489
,共6页
张文杰%杜绍财%杨建军%屈延%毛维武%李静%李朝霞%田淑菊%龚晏萱
張文傑%杜紹財%楊建軍%屈延%毛維武%李靜%李朝霞%田淑菊%龔晏萱
장문걸%두소재%양건군%굴연%모유무%리정%리조하%전숙국%공안훤
肝炎,丙型%基因重组%干扰素α
肝炎,丙型%基因重組%榦擾素α
간염,병형%기인중조%간우소α
Chronic hepatitis C%Genetic recombination%Interferon-α
目的 探讨兰州地区9例丙型肝炎患者5'-非编码区(5'-NCR)和C区基因型变异及与干扰素α(IFN α)疗效的关系.方法 应用限制性内切酶分析和NCBI基因分型方法检测9例经IFN α-2b治疗的HCV感染患者的5'-NCR和C区基因型,筛选HCV前后基因型不一致的病例. 结果 9例IFNα治疗的丙型肝炎患者中,5例获得持续病毒学应答,其中2例HCV基因型为2a型,3例为无MboⅠ切点的1b型.4例IFNα抵抗的病例,其中1例HCV基因型为2a型,但存在着1b与2a混合状态;另1例HCV 5 '-NCR为2i基因型,C区和NS5区为2a基因型;其余2例HCV 5'-NCR和C区均为1b型.9例IFNα抗病毒治疗的丙型肝炎患者中,除HCV基因型为2型的患者之外,在HCV 1型患者中,-221bp位点均为无MboⅠ切点株,在这7例普通IFα无效病例中,改用聚乙二醇IFN α-2a联合利巴韦林抗病毒治疗后,其中5例HCV RNA阴转,阴转率为71.4‰ 结论 兰州地区经普通IFNα治疗无效的HCV患者中存在基因型前后不一致现象,基因重组患者经聚乙二醇IFN α-2a联合利巴韦林治疗持续病毒学应答率明显优于普通IFNα联合利巴韦林.
目的 探討蘭州地區9例丙型肝炎患者5'-非編碼區(5'-NCR)和C區基因型變異及與榦擾素α(IFN α)療效的關繫.方法 應用限製性內切酶分析和NCBI基因分型方法檢測9例經IFN α-2b治療的HCV感染患者的5'-NCR和C區基因型,篩選HCV前後基因型不一緻的病例. 結果 9例IFNα治療的丙型肝炎患者中,5例穫得持續病毒學應答,其中2例HCV基因型為2a型,3例為無MboⅠ切點的1b型.4例IFNα牴抗的病例,其中1例HCV基因型為2a型,但存在著1b與2a混閤狀態;另1例HCV 5 '-NCR為2i基因型,C區和NS5區為2a基因型;其餘2例HCV 5'-NCR和C區均為1b型.9例IFNα抗病毒治療的丙型肝炎患者中,除HCV基因型為2型的患者之外,在HCV 1型患者中,-221bp位點均為無MboⅠ切點株,在這7例普通IFα無效病例中,改用聚乙二醇IFN α-2a聯閤利巴韋林抗病毒治療後,其中5例HCV RNA陰轉,陰轉率為71.4‰ 結論 蘭州地區經普通IFNα治療無效的HCV患者中存在基因型前後不一緻現象,基因重組患者經聚乙二醇IFN α-2a聯閤利巴韋林治療持續病毒學應答率明顯優于普通IFNα聯閤利巴韋林.
목적 탐토란주지구9례병형간염환자5'-비편마구(5'-NCR)화C구기인형변이급여간우소α(IFN α)료효적관계.방법 응용한제성내절매분석화NCBI기인분형방법검측9례경IFN α-2b치료적HCV감염환자적5'-NCR화C구기인형,사선HCV전후기인형불일치적병례. 결과 9례IFNα치료적병형간염환자중,5례획득지속병독학응답,기중2례HCV기인형위2a형,3례위무MboⅠ절점적1b형.4례IFNα저항적병례,기중1례HCV기인형위2a형,단존재착1b여2a혼합상태;령1례HCV 5 '-NCR위2i기인형,C구화NS5구위2a기인형;기여2례HCV 5'-NCR화C구균위1b형.9례IFNα항병독치료적병형간염환자중,제HCV기인형위2형적환자지외,재HCV 1형환자중,-221bp위점균위무MboⅠ절점주,재저7례보통IFα무효병례중,개용취을이순IFN α-2a연합리파위림항병독치료후,기중5례HCV RNA음전,음전솔위71.4‰ 결론 란주지구경보통IFNα치료무효적HCV환자중존재기인형전후불일치현상,기인중조환자경취을이순IFN α-2a연합리파위림치료지속병독학응답솔명현우우보통IFNα연합리파위림.
Objective To investigate Lanzhou area cases of hepatitis C virus (H-CV) infection with a 5'-non coding region (NCR) 2i genotype and core (C),envelope protein (E) and non-structural protein (NS5) 2a genotype and the relationship with therapeutic response to interferon-alpha (IFNα).Methods Nine patients who received IFNα-based treatment for HCV between 2007 and 2009 at the Second People's Hospital of Gansu Province were selected for analysis.Restriction enzyme analysis was carried out for the 5'-NCR and sequencing was carried out for the other gene areas.The relationship between genetic variants and IFNαresponse was examined.Results Of the total nine HCV cases treated with IFNα-based therapies,five of the patients achieved sustained virological response (SVR),which included two cases with type 2 genotype and three cases with no MboI restriction enzyme point of tangency (i.e.type 1b).The remaining four patients that did not achieve SVR included one case of type 2a,with a 1b and 2a mixed state,and one case with 5'-NCR 2i genotype and C area,NS5 area 2a genotype; the other two cases had 5'-NCR and C area type 1b.Of the five cases with 5'-NCR 2i genotype,all had C 2a genotype and two had C/E 2a and NS5 2a genotypes.The seven patients that showed no response to ordinary IFNα were converted to long-term IFNα plus ribavirin combination antiviral treatment; five (71.4％) of the cases showed response in HCV RNA level and the patients treated with the pegylated form showed greater response.Conclusion HCV genotyping can only provide information on the particular region of gene sequence examined,and it is important to sequence all gene regions where mutations related to antiviral drug response are located.Peg-IFNα-2a combined with ribavirin may achieve better therapeutic effect in patients infected with 2i/2a recombinant forms of HCV.
