广西医学
廣西醫學
엄서의학
Guangxi Medical Journal
2015年
9期
1209-1211
,共3页
乙型肝炎病毒感染%隐匿性%preS/S区%突变%缺失%肝损害
乙型肝炎病毒感染%隱匿性%preS/S區%突變%缺失%肝損害
을형간염병독감염%은닉성%preS/S구%돌변%결실%간손해
Hepatitis B virus infection%Occult%preS/S gene%Mutation%Deletion%Hepatic damage
目的：初步探讨HBV preS／S区基因变异与隐匿性HBV感染（ OBI ）、肝脏损伤的关系。方法收集116例HBsAg阴性（从乙型肝炎康复患者中选取）及102例HBsAg阳性患者的血清进行 DNA提取，使用巢式PCR对针对preS／S区、pre-core／core区及X基因区进行检测，确定OBI例数，并对克隆标本的preS／S区全长基因进行测序分析，分别对比OBI患者和HBsAg患者、伴有严重肝损伤的OBI患者和HBsAg阳性患者的preS／S区基因序列。结果 OBI检出率为60．34％（70／116），OBI患者M1I、Q2K、Q129N／R／P、S210R及G185R的突变频率均明显高于HBsAg阳性患者（P＜0．05），OBI患者的preS缺失率亦高于HBsAg阳性患者（P＜0．05）；伴有严重肝损伤的OBI患者Q129N／R／P突变频率及preS缺失率与伴有严重肝损伤HBsAg阳性患者比较，差异无统计学意义（P＞0．05），但M1I、Q2K、S210R及G185R突变频率均明显高于均明显高于伴有严重肝损伤HBsAg阳性患者（P＜0．05）。结论 M1I、Q2K、Q129N／R／P、S210R及G185R的突变及preS缺失对诊断OBI有一定的指导作用，当患者存在肝损伤时Q129N／R／P变异及preS缺失对诊断OBI的指导作用可能受影响。
目的：初步探討HBV preS／S區基因變異與隱匿性HBV感染（ OBI ）、肝髒損傷的關繫。方法收集116例HBsAg陰性（從乙型肝炎康複患者中選取）及102例HBsAg暘性患者的血清進行 DNA提取，使用巢式PCR對針對preS／S區、pre-core／core區及X基因區進行檢測，確定OBI例數，併對剋隆標本的preS／S區全長基因進行測序分析，分彆對比OBI患者和HBsAg患者、伴有嚴重肝損傷的OBI患者和HBsAg暘性患者的preS／S區基因序列。結果 OBI檢齣率為60．34％（70／116），OBI患者M1I、Q2K、Q129N／R／P、S210R及G185R的突變頻率均明顯高于HBsAg暘性患者（P＜0．05），OBI患者的preS缺失率亦高于HBsAg暘性患者（P＜0．05）；伴有嚴重肝損傷的OBI患者Q129N／R／P突變頻率及preS缺失率與伴有嚴重肝損傷HBsAg暘性患者比較，差異無統計學意義（P＞0．05），但M1I、Q2K、S210R及G185R突變頻率均明顯高于均明顯高于伴有嚴重肝損傷HBsAg暘性患者（P＜0．05）。結論 M1I、Q2K、Q129N／R／P、S210R及G185R的突變及preS缺失對診斷OBI有一定的指導作用，噹患者存在肝損傷時Q129N／R／P變異及preS缺失對診斷OBI的指導作用可能受影響。
목적：초보탐토HBV preS／S구기인변이여은닉성HBV감염（ OBI ）、간장손상적관계。방법수집116례HBsAg음성（종을형간염강복환자중선취）급102례HBsAg양성환자적혈청진행 DNA제취，사용소식PCR대침대preS／S구、pre-core／core구급X기인구진행검측，학정OBI례수，병대극륭표본적preS／S구전장기인진행측서분석，분별대비OBI환자화HBsAg환자、반유엄중간손상적OBI환자화HBsAg양성환자적preS／S구기인서렬。결과 OBI검출솔위60．34％（70／116），OBI환자M1I、Q2K、Q129N／R／P、S210R급G185R적돌변빈솔균명현고우HBsAg양성환자（P＜0．05），OBI환자적preS결실솔역고우HBsAg양성환자（P＜0．05）；반유엄중간손상적OBI환자Q129N／R／P돌변빈솔급preS결실솔여반유엄중간손상HBsAg양성환자비교，차이무통계학의의（P＞0．05），단M1I、Q2K、S210R급G185R돌변빈솔균명현고우균명현고우반유엄중간손상HBsAg양성환자（P＜0．05）。결론 M1I、Q2K、Q129N／R／P、S210R급G185R적돌변급preS결실대진단OBI유일정적지도작용，당환자존재간손상시Q129N／R／P변이급preS결실대진단OBI적지도작용가능수영향。
Objective To preliminarily investigate the relationship of genetic variation of HBV preS /S region with occult hepatitis B virus infection(OBI) or hepatic damage.Methods One hundred and sixteen cases of negative HBsAg selected from hepatitis B patients and 102 cases of positive HBsAg were enrolled in the study .Their serum samples were obtained for DNA extraction .The regions of preS/S, pre-core/core and X gene were detected using nested PCR for confirming OBI .The samples of cloned pres/S gene were sequenced ,and a comparison of pres/S gene sequence was conducted between patients with OBI and with HBsAg ,as well as between patients with OBI and severe hepatic damage and patients with positive gene and severe hepatic damage.Results The detection rate of OBI was 60.34%(70/116). OBI patients owned significantly higher mutation frequencies of M1I,Q2K,Q129N/R/P,S210R and G185R as well as a higher deletion rate of preS compared to the patients with positive HBsAg(P<0.05).There was no significant difference in the mutation frequency of Q129N/R/P or deletion rate of preS between OBI patients with severe hepatic damage and patients with positive HBsAg and severe hepatic damage (P>0.05). But patients with OBI and severe hepatic damage had significantly higher mutation frequencies of M1I,Q2K,S210R and G185R compared to patients with positive HBsAg and severe hepatic damage (P<0.05).Conclusion The mutation of M1I,Q2K ,Q 129N/R/P,S210R and G185R as well as the preS deletion is valuable for diagnostic guidance in OBI .However,the guidance of Q129N/R/P mutation and preS deletion in the diagnosis of OBI might be affected when patients suffer from hepatic damage .
