CAJ | 학술논문

目的探讨山西省乙型肝炎病毒(HBV)基因型和基因亚型的分布及不同HBV基因型和基因亚型感染患者临床转归差异.方法纳入2013年2月至2014年7月山西医科大学第一医院慢性HBV感染患者266例,包括慢性乙型肝炎患者159例(慢性乙型肝炎组)、乙型肝炎相关性肝硬化患者89例(乙型肝炎相关性肝硬化组)和乙型肝炎相关性肝癌患者(乙型肝炎相关性肝癌组)18例.采用特异性巢式聚合酶链反应检测HBV基因型和基因亚型,分析各组HBV基因型和基因亚型分布和各型HBV感染患者临床转归差异.结果 266例样本检出HBV B基因型32例(12.0％),均为B2基因亚型;C基因型229例(86.1％),均为C2基因亚型;B/C混合型5例(1.9％).C型(C2亚型)较B型(B2亚型)HBV感染患者男性比例更高、年龄更大、病程更长[66.8％ (153/229)比46.9％(15/32),43.00岁(32.00岁,51.00岁)比29.00岁(25.00岁,38.25岁),4.00年(2.00年,9.00年)比2.00年(2.00年,2.75年)](P＜0.05).B型(B2亚型)HBV感染患者中,慢性乙型肝炎患者占81.3％ (26/32)、乙型肝炎相关性肝硬化占18.8％(6/32),C型(C2亚型)HBV感染患者中,慢性乙型肝炎患者占55.9％(128/229)、乙型肝炎相关性肝硬化占36.2％(83/229)、乙型肝炎相关性肝癌占7.9％(18/229),2型比较差异有统计学意义(x2=8.09,P=0.02).结论山西省慢性HBV感染患者中HBV基因型包括B型(B2亚型)、C型(C2亚型)及B/C混合型,以C型(C2亚型)为主,C型(C2亚型)HBV感染临床转归不良.
목적 탐토산서성을형간염병독(HBV)기인형화기인아형적분포급불동HBV기인형화기인아형감염환자림상전귀차이.방법 납입2013년2월지2014년7월산서의과대학제일의원만성HBV감염환자266례,포괄만성을형간염환자159례(만성을형간염조)、을형간염상관성간경화환자89례(을형간염상관성간경화조)화을형간염상관성간암환자(을형간염상관성간암조)18례.채용특이성소식취합매련반응검측HBV기인형화기인아형,분석각조HBV기인형화기인아형분포화각형HBV감염환자림상전귀차이.결과 266례양본검출HBV B기인형32례(12.0％),균위B2기인아형;C기인형229례(86.1％),균위C2기인아형;B/C혼합형5례(1.9％).C형(C2아형)교B형(B2아형)HBV감염환자남성비례경고、년령경대、병정경장[66.8％ (153/229)비46.9％(15/32),43.00세(32.00세,51.00세)비29.00세(25.00세,38.25세),4.00년(2.00년,9.00년)비2.00년(2.00년,2.75년)](P＜0.05).B형(B2아형)HBV감염환자중,만성을형간염환자점81.3％ (26/32)、을형간염상관성간경화점18.8％(6/32),C형(C2아형)HBV감염환자중,만성을형간염환자점55.9％(128/229)、을형간염상관성간경화점36.2％(83/229)、을형간염상관성간암점7.9％(18/229),2형비교차이유통계학의의(x2=8.09,P=0.02).결론 산서성만성HBV감염환자중HBV기인형포괄B형(B2아형)、C형(C2아형)급B/C혼합형,이C형(C2아형)위주,C형(C2아형)HBV감염림상전귀불량.
Objective To investigate the distribution of hepatitis B virus (HBV) genotype and subgenotype in Shanxi province,and to analyze the clinical outcomes of patients infected with different genotype and subgenotype of HBV.Methods Totally 266 patients of chronic HBV infection from February 2013 to July 2014 were enrolled,including 159 cases of chronic hepatitis B (hepatitis group),89 cases of cirrhosis (cirrhosis group) and 18 cases of hepatocarcinoma (hepatocarcinoma group).The genotype and subgenotype of HBV were determined by Nested polymerase chain reaction (ntPCR).The distribution of the genotype and subgenotype of HBV and the clinical outcomes were analyzed.Results In 266 cases,32 (12.0％) were found to be genotype B (all subgenotype B2);229 (86.1％) were genotype C (all subgenotype C2);5 (1.9％) were genotype B/C.Compared with the patients with genotype B (subgenotype B2) HBV infection,the patients with genotype C (subgenotype C2) had higher proportions of male,older age and longer duration [66.8％ (153/229) vs 46.9％ (15/32),43.00 years (32.00 years,51.00 years) vs 29.00 years (25.00 years,38.25 years),4.00 years (2.00 years,9.00 years) vs 2.00 years (2.00 years,2.75 years)] (P ＜ 0.05).In patients with genotype B (subgenotype B2) HBV infection,there were 81.3％ (26/32) of hepatitis and 18.8％ (6/32) of cirrhosis;in patients with genotype C (subgenotype C2) HBV infection,there were 55.9％ (128/229) of hepatitis,36.2％ (83/229) of cirrhosis and 7.9％ (18/229) of hepatocarcinoma,showing significant differences among different genotypes (x2 =8.09,P =0.02).Conclusions There are genotype B (subgenotype B2),genotype C (subgenotype C2) and genotype B/C HBV in patients with chronic HBV infection infection in Shanxi province.The genotype C (subgenotype C2) HBV infection is predominant with poor clinical outcomes.