实用肝脏病杂志
實用肝髒病雜誌
실용간장병잡지
Journal of Practical Hepatology
2015年
6期
581-584
,共4页
哈明昊%佘会元%吴建秋%孙莉萍%沈文娟%黄钟鸣%陈晓兰%单文艳%何慧芳
哈明昊%佘會元%吳建鞦%孫莉萍%瀋文娟%黃鐘鳴%陳曉蘭%單文豔%何慧芳
합명호%사회원%오건추%손리평%침문연%황종명%진효란%단문염%하혜방
乙型肝炎%细胞毒性T淋巴细胞%抗原表位%变异
乙型肝炎%細胞毒性T淋巴細胞%抗原錶位%變異
을형간염%세포독성T림파세포%항원표위%변이
Hepatitis B%Mutation%Cytotoxic T lymphocytes%Epitope
目的:探讨HBV包膜区和核心区细胞毒性T淋巴细胞(CTL)抗原表位变异的规律及对疾病发展转归的影响。方法本研究选择无症状HBsAg携带者(ASC)38例,慢性乙型肝炎(CHB)35例,乙型肝炎肝硬化(LC)23例。采用DNA测序法检测HBV包膜区和核心区病毒序列及表位变异情况,并分析其与临床转归的关系。结果在入组患者中,HBV包膜区CTL抗原表位41~49、88~96、97~108、172~180和185~194变异率分别为48个(55.2%)、13个(14.9%)、11个(12.6%)、9个(10.3%)和6个(6.9%);HBV CTL 41~49位变异率在CHB和肝硬化患者中的变异率分别为60.0%和65.2%,显著高于ASC[31.6%,P<0.05];HBV核心区CTL抗原表位18~27和91~95的变异率分别为18个(56.2%)和14个(43.8%),HBV CTL18~27位的变异率在慢性乙型肝炎和肝硬化患者中分别为20.0%和30.4%,显著高于ASC[10.5%,P<0.05];多变量分析表明,HBV核心区CTL 41~49的变异是预示HBV感染后患者肝内炎症活动、慢性乙型肝炎病程进展、迁延并发生肝炎肝硬化的独立危险因素。结论 HBV CTL变异是HBV感染慢性化的重要原因,预示病情将进展或加重。
目的:探討HBV包膜區和覈心區細胞毒性T淋巴細胞(CTL)抗原錶位變異的規律及對疾病髮展轉歸的影響。方法本研究選擇無癥狀HBsAg攜帶者(ASC)38例,慢性乙型肝炎(CHB)35例,乙型肝炎肝硬化(LC)23例。採用DNA測序法檢測HBV包膜區和覈心區病毒序列及錶位變異情況,併分析其與臨床轉歸的關繫。結果在入組患者中,HBV包膜區CTL抗原錶位41~49、88~96、97~108、172~180和185~194變異率分彆為48箇(55.2%)、13箇(14.9%)、11箇(12.6%)、9箇(10.3%)和6箇(6.9%);HBV CTL 41~49位變異率在CHB和肝硬化患者中的變異率分彆為60.0%和65.2%,顯著高于ASC[31.6%,P<0.05];HBV覈心區CTL抗原錶位18~27和91~95的變異率分彆為18箇(56.2%)和14箇(43.8%),HBV CTL18~27位的變異率在慢性乙型肝炎和肝硬化患者中分彆為20.0%和30.4%,顯著高于ASC[10.5%,P<0.05];多變量分析錶明,HBV覈心區CTL 41~49的變異是預示HBV感染後患者肝內炎癥活動、慢性乙型肝炎病程進展、遷延併髮生肝炎肝硬化的獨立危險因素。結論 HBV CTL變異是HBV感染慢性化的重要原因,預示病情將進展或加重。
목적:탐토HBV포막구화핵심구세포독성T림파세포(CTL)항원표위변이적규률급대질병발전전귀적영향。방법본연구선택무증상HBsAg휴대자(ASC)38례,만성을형간염(CHB)35례,을형간염간경화(LC)23례。채용DNA측서법검측HBV포막구화핵심구병독서렬급표위변이정황,병분석기여림상전귀적관계。결과재입조환자중,HBV포막구CTL항원표위41~49、88~96、97~108、172~180화185~194변이솔분별위48개(55.2%)、13개(14.9%)、11개(12.6%)、9개(10.3%)화6개(6.9%);HBV CTL 41~49위변이솔재CHB화간경화환자중적변이솔분별위60.0%화65.2%,현저고우ASC[31.6%,P<0.05];HBV핵심구CTL항원표위18~27화91~95적변이솔분별위18개(56.2%)화14개(43.8%),HBV CTL18~27위적변이솔재만성을형간염화간경화환자중분별위20.0%화30.4%,현저고우ASC[10.5%,P<0.05];다변량분석표명,HBV핵심구CTL 41~49적변이시예시HBV감염후환자간내염증활동、만성을형간염병정진전、천연병발생간염간경화적독립위험인소。결론 HBV CTL변이시HBV감염만성화적중요원인,예시병정장진전혹가중。
Objective To investigate the impact of cytotoxic T lymphocyte (CTL) epitope mutation of HBV envelope and core protein on disease progress in patients with hepatitis B. Methods 38 individuals with asymptomatic HBsAg carrier,35 patients with chronic hepatitis B and 23 with liver cirrhosis were recruited in this study. Gene sequencing analysis of HBV core region and envelope region was carried out in all enrolled patients to unveil any possible CTL epitope mutation. Results The mutation rates of locus 41~49,88~96,97~108,172~180 and 185~194 of CTL epitope in HBV envelope region were 48(55.2%),13(14.9%),11(12.6%),9(10.3%) and 6 (6.9%),respectively;60% of mutation at locus 41~49 in patients with chronic hepatitis B and 65.2% in with liver cirrhosis were significantly higher than 31.6% in asymptomatic HBsAg carriers(P<0.05);the mutation rates at 18~27 and 91~95 locus of CTL epitope in HBV core region were 56.2% and 43.8%,respectively;the mutation rates at locus 18~27 were also higher in patients with CHB (20.0%) and LC (30.4%) than that in asymptomatic HBsAg carriers (10.5%,P<0.05);Multivariate analysis showed that locus 41~49 mutation was an independent risk factor for the progress of CHB to LC. Conclusion CTL epitope mutation of HBV is a significant cause for the chronicity of hepatitis B virus infection.