国际检验医学杂志
國際檢驗醫學雜誌
국제검험의학잡지
INTERNATIONAL JOURNAL OF LABORATORY MEDICINE
2014年
24期
3336-3337,3340
,共3页
耐药突变%基因型%慢性乙型肝炎
耐藥突變%基因型%慢性乙型肝炎
내약돌변%기인형%만성을형간염
resistance mutations%genotype%chronic hepatitis B
目的：研究太仓地区慢性乙肝患者耐药突变和基因型分布情况，及 HBV 基因型与耐药突变的相关性。方法选择太仓地区350例慢性乙型肝炎患者，在使用核苷（酸）类药物抗病毒前，检测患者耐药突变及基因型情况，分析患者耐药突变与基因型的相关性。结果350例慢性乙肝患者，HBV 基因型分布：B 基因型172例，占49.14％；C 基因型164例，占46.85％；其中 D基因型9例，占2.57％；B、C 混合型基因型有5例，占1.42％；未发现其他基因型。本研究共检出58例耐药突变患者，其中 B 基因型22例，C 基因型35例，D 基因型1例，B、C 混合基因型患者未发现耐药突变。耐药突变位点：与拉米夫定相关的耐药突变36例（10.28％），与阿德福韦相关的耐药突变16例（4.57％），与恩替卡韦相关的耐药突变6例（1.71％）。结论太仓地区慢性乙肝患者 HBV 基因型以 B、C 型为主，2种基因型占90％以上，两种基因型比例相似。C 基因型患者发生耐药突变的比例较 B 基因型高，拉米夫定相关的耐药突变比例最高。建议对用药史不明确、复发再治疗的慢性乙肝患者，在接受核苷（酸）类药物治疗前进行耐药检测，选择针对性治疗方案。
目的：研究太倉地區慢性乙肝患者耐藥突變和基因型分佈情況，及 HBV 基因型與耐藥突變的相關性。方法選擇太倉地區350例慢性乙型肝炎患者，在使用覈苷（痠）類藥物抗病毒前，檢測患者耐藥突變及基因型情況，分析患者耐藥突變與基因型的相關性。結果350例慢性乙肝患者，HBV 基因型分佈：B 基因型172例，佔49.14％；C 基因型164例，佔46.85％；其中 D基因型9例，佔2.57％；B、C 混閤型基因型有5例，佔1.42％；未髮現其他基因型。本研究共檢齣58例耐藥突變患者，其中 B 基因型22例，C 基因型35例，D 基因型1例，B、C 混閤基因型患者未髮現耐藥突變。耐藥突變位點：與拉米伕定相關的耐藥突變36例（10.28％），與阿德福韋相關的耐藥突變16例（4.57％），與恩替卡韋相關的耐藥突變6例（1.71％）。結論太倉地區慢性乙肝患者 HBV 基因型以 B、C 型為主，2種基因型佔90％以上，兩種基因型比例相似。C 基因型患者髮生耐藥突變的比例較 B 基因型高，拉米伕定相關的耐藥突變比例最高。建議對用藥史不明確、複髮再治療的慢性乙肝患者，在接受覈苷（痠）類藥物治療前進行耐藥檢測，選擇針對性治療方案。
목적：연구태창지구만성을간환자내약돌변화기인형분포정황，급 HBV 기인형여내약돌변적상관성。방법선택태창지구350례만성을형간염환자，재사용핵감（산）류약물항병독전，검측환자내약돌변급기인형정황，분석환자내약돌변여기인형적상관성。결과350례만성을간환자，HBV 기인형분포：B 기인형172례，점49.14％；C 기인형164례，점46.85％；기중 D기인형9례，점2.57％；B、C 혼합형기인형유5례，점1.42％；미발현기타기인형。본연구공검출58례내약돌변환자，기중 B 기인형22례，C 기인형35례，D 기인형1례，B、C 혼합기인형환자미발현내약돌변。내약돌변위점：여랍미부정상관적내약돌변36례（10.28％），여아덕복위상관적내약돌변16례（4.57％），여은체잡위상관적내약돌변6례（1.71％）。결론태창지구만성을간환자 HBV 기인형이 B、C 형위주，2충기인형점90％이상，량충기인형비례상사。C 기인형환자발생내약돌변적비례교 B 기인형고，랍미부정상관적내약돌변비례최고。건의대용약사불명학、복발재치료적만성을간환자，재접수핵감（산）류약물치료전진행내약검측，선택침대성치료방안。
Objective To study the distribution of drug resistance mutations and genotypes in the patients with chronic hepatitis B(CHB)in Taicang area.Methods 350 cases of CHB were selected and detect the drug resistance mutations and genotypes before using nucleoside(acid)anti-viral drugs.The correlation between the drug resistance mutations with genotypes in CHB patients was analyzed.Results Among 350 cases of CHB,the distribution of genotypes was genotype B in 172 cases,accounting for 49.14%, genotype C in 164 cases,accounting for 46.85%,genotype D in 9 cases,accounting for 2.57%,mixed genotype of B and C in 5 ca-ses,accounting for 1.42%,no other genotypes were found.In this study,the drug resistance mutations were detected in 58 cases,in-cluding 22 cases of genotype B,35 cases of genotype C and 1 case of genotype D,no drug resistance mutations were found in mixed genotype B and C.The drug resistance mutations sites:lamivudine resistance-associated mutations in 36 cases(10.28%),and adefo-vir resistance-associated mutations in 16 cases(4.57%)and entecavir associated resistance mutations in 6 cases(1.71%).Conclusion The genotype of CHB patients in Taicang area was dominated by genotype B and C,which accounting for more than 90% and the proportion of these two kinds of genotype is similar.The proportion of drug resistance mutation occurrence in the patients with gen-otype C is higher than that with genotype B.The lamivudine resistance-associated mutation has the highest proportion of drug re-sistance occurrence.It is suggested that the CHB patients with undefined medication history and recurrence treatment should be per-formed the drug resistance detection for selecting the targeted therapeutic schemes before accepting nucleoside(acid)drug therapy.
