CAJ | 학술논문

目的探讨乙型肝炎病毒(HBV)X基因突变在HBV相关性肾小球肾炎(HBV-GN)发病中的意义.方法分别从50例HBV-GN患者及60例无症状乙肝病毒携带者(对照组)中采集静脉血,提取DNA测定HBV DNA含量并以聚合酶链反应技术对HBV DNA的X基因进行扩增,并对扩增产物进行测序.测定50例HBV-GN患者24h尿蛋白量.结果 (1)HBV-GN组和对照组的年龄及男女比例差异无统计学意义(P＞ 0.05);42例X基因变异HBV-GN患者与对照组间HBV DNA复制水平差异无统计学意义(P＞ 0.05);42例伴有X基因变异HBV-GN患者24 h尿蛋白量高于无X基因变异HBV-GN患者,差异有统计学意义(P＜0.05).(2)HBV-GN组有42例发生了核苷酸序列点突变,并导致了氨基酸的替代,占总人数的84％,核苷酸序列错义突变主要发生于以下位点:nt1653、nt1726、nt1727、nt1730、nt1753、nt1762、nt1764,突变位点集中在X基因反式作用调控区.(3)对照组中有5例发生了核苷酸序列错义突变,仅占8％,分别是nt1632及nt1635,且突变均在非功能区域.结论大多数HBV-GN患者存在X基因一些关键位点的突变,并导致了氨基酸的替代,X基因突变HBV-GN患者尿蛋白量增加,提示这些关键位点的突变可能在HBV-GN的致病中起到重要作用.
목적 탐토을형간염병독(HBV)X기인돌변재HBV상관성신소구신염(HBV-GN)발병중적의의.방법 분별종50례HBV-GN환자급60례무증상을간병독휴대자(대조조)중채집정맥혈,제취DNA측정HBV DNA함량병이취합매련반응기술대HBV DNA적X기인진행확증,병대확증산물진행측서.측정50례HBV-GN환자24h뇨단백량.결과 (1)HBV-GN조화대조조적년령급남녀비례차이무통계학의의(P＞ 0.05);42례X기인변이HBV-GN환자여대조조간HBV DNA복제수평차이무통계학의의(P＞ 0.05);42례반유X기인변이HBV-GN환자24 h뇨단백량고우무X기인변이HBV-GN환자,차이유통계학의의(P＜0.05).(2)HBV-GN조유42례발생료핵감산서렬점돌변,병도치료안기산적체대,점총인수적84％,핵감산서렬착의돌변주요발생우이하위점:nt1653、nt1726、nt1727、nt1730、nt1753、nt1762、nt1764,돌변위점집중재X기인반식작용조공구.(3)대조조중유5례발생료핵감산서렬착의돌변,부점8％,분별시nt1632급nt1635,차돌변균재비공능구역.결론 대다수HBV-GN환자존재X기인일사관건위점적돌변,병도치료안기산적체대,X기인돌변HBV-GN환자뇨단백량증가,제시저사관건위점적돌변가능재HBV-GN적치병중기도중요작용.
Objective To determine whether mutation of Hepatitis B virus (HBV) X gene is associated with hepatitis B virus-associated glomerulonephritis (HBV-GN).Methods The venous blood was collected from 50 patients with HBV-GN and 60 patients with asymptomatic HBV carriers (control group).Serum HBV DNA was extracted to determine the serum titer of HBV-DNA and then polymerase chain reaction (PCR) was used to detect the HBV X gene mutation.Results (1)There were not statistical significance between age and gender in HBV-GN group and control group (P ＞0.05).There were not statistical significance of serum replication level of HBV DNA in HBV-GN with X gene mutation and control group (P ＞ 0.05).Urine protein excretion in HBV-GN group with or without X gene mutation was found with statistical significance (P ＜ 0.05).(2)Nucleotide mutations [84％ (42/50)] resulted in amino acid substitution in HBV-GN.Nucleotide mutations changed in transfunction control region of X gene,including position nt1653,nt1726,nt1727,nt1730,nt1753,nt1762 and nt1764.(3)Nucleotide mutations [8％(5/60)] resulted in amino acid substitution in control group.Nucleotide mutations changed in position nt1632 and nt1635,located in non-functional region.Conclusions HBV X gene mutations and the subsequent amino acid substitutions are found in HBV-GN.The urine protein excretion level increases in patients with X mutation,suggesting that these mutations may play an important role in the pathogenesis of HBV-GN.